
Class 

Book 



^ iS^VT* 



CQEXRIGHT DEPOSm 



GOOD HEALTH 



GOOD HEALTH 



HOW TO GET IT AND HOW TO KEEP IT 



BY 

ALVAH H. DOTY, M.D. 

AUTHOR OF "THE PREVENTION OF INFECTIOUS DISEASES," "THE MOSQIHTO," 

"A MANUAL OF INSTRUCTION IN THE PRINCIPLES OF PROMPT 

AID TO THE INJURED," ETC. 




ILLUSTRATED 



D. APPLETON AND COMPANY 

NEW YORK LONDON 

1917 






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"^ ^i 



^1 



Copyright, 1917, by 
D. APPLETON AND COMPANY 



JUL 25 I9i/ 

©CI.A470411 



W^ TO MY FRIEND 

DR. T. MITCHELL PRUDDEN 



A TRIBUTE TO MANY YEARS 
OF PLEASANT PERSONAL AND 
PROFESSIONAL ASSOCIATION 



PREFACE 

Years ago it was believed that matters relating to the 
preservation of health and the prevention of disease should 
be left in the hands of physicians, and little effort was made 
by the public in aid of this important work. Now we know 
that the health of a community depends chiefly upon the 
exertion of its individual members in maintaining not only 
their own well-being, but also that of their neighbor. This 
newer conception has recently led to a stimulation of interest 
in this subject, and societies are being organized to bring 
about personal cooperation in carrying out the laws of 
hygiene and sanitation. It is essential that the public 
should become familiar with recent advances which have 
been made along these lines, for many of the older theories 
regarding the care and protection of the body, and the 
means by which diseases are transmitted, have been proved 
to be erroneous. 

It is an extremely difficult task for the medical profession, 
as well as health departments and other public agencies, to 
attempt to combat physical inefficiency, ill health, and disease 
without the cooperation of those for whom their efforts are 
so generously expended. There should be not a mere passive 
acquiescence in following the teaching of sanitarians or in 
complying with health ordinances, but an intelligent appre- 
ciation of the fundamental principles which animate them 
and a definite sense of responsibility in maintaining bodily 
health for both individual and social ends. 

The terms ''hygiene^' and ' ^sanitation' ^ are very much alike 
in their meaning and are commonly used interchangeably. By 



Viii PREFACE 

way of clearer definition, it may be said that hygiene refers 
more particularly to the care of the body, while sanitation 
relates rather to the methods of maintaining healthful con- 
ditions in the environment and covers matters of a more 
general and extended character; for instance, school sanita- 
tion, sanitation of the workshop, and municipal sanitation. 
It is sufficient to know that both refer to the preservation of 
health and the prevention of disease. 

It has been the aim of the author to include in this book 
the essential and salient points in the construction of the 
body and function of its various parts; also to discuss pub- 
lic health problems, the maintenance of individual physical 
well-being, the means by which infectious diseases are trans- 
mitted and how they may be prevented, the importance of 
pure air, good water and nourishing food, as well as other 
matters connected with the subject of hygiene. The author 
has endeavored to present these in a clear and simple 
manner, and in a way that will make the application of the 
information practicable in everyday life and conduct. 



CONTENTS 

CHAPTER I 

PAGE 

THE STRUCTURE OF THE BODY i 

The Skeleton — Articulation — ^Joints — Muscles — 
Blood. 

CHAPTER II 
THE VITAL PROCESSES: CIRCULATION, RES- 
PIRATION, DIGESTION, NERVOUS SYSTEM 
AND LYMPHATIC SYSTEM 23 

Circulation — Blood-vessels — Heart — Respiration — 
Digestion — Kidneys — Skin — Spleen — Nervous 
System — Lymphatic System. 

CHAPTER III 
AIR 62 

CHAPTER IV 

WATER 69 

Preparation of Food — Distribution of Meals — Re- 
duction of Weight. 

CHAPTER V 

FOOD 86 

Nutrition — Diet — Preparation of Food — Distribu- 
tion of Meals — Reduction of Weight. 

CHAPTER VI 
DISPOSAL OF WASTE 122 

Sewage — Garbage . 

ix 



X CONTENTS 

CHAPTER VII PAGE 

VENTILATION 133 

CHAPTER VIII 
HEATING AND LIGHTING ....... 141 

Heating — Lighting. 

CHAPTER IX 
PERSONAL HYGIENE 147 

Food and Drink — Exercise — Bathing — Teeth — Eyes 
— Hands and Feet — Sleep — Clothing — Constipation 
— ^Vacations. 

CHAPTER X 
HYGIENE OF THE HOME, SCHOOL AND WORK- 
SHOP 176 

Hygiene of the Home — Hygiene of the School — 
Hygiene of the Workshop. 

CHAPTER XI 
BACTERIA, INFECTIOUS DISEASES AND THE 
MEANS BY WHICH THEY ARE TRANSMITTED 192 
Bacteria — Infectious Diseases and the Means by 
Which They are Transmitted. 

CHAPTER XII 
MOSQUITOES AND FLIES AND THEIR EXTER- 
MINATION 204 

Flies. 

CHAPTER XIII 
TUBERCULOSIS 225 

CHAPTER XIV 
DISINFECTANTS AND DEODORANTS .... 235 



CONTENTS xi 

CHAPTER XV PAGE 

PROMPT AID TO THE INJURED 242 

Hemorrhage — Shock — Collapse — Electric Shock — 
Instructions for Resuscitation — Syncope — Fainting 
^Apoplexy or Stroke of Paralysis — Epilepsy — Hys- 
teria — Heat-Stroke, Sun-Stroke, Insolation, Sun 
Fever, Fever Heat — Asphyxiation — Suffocation — 
Drowning — Burns and Scalds — Frost-Bite — Wounds 
— Fractures — Dislocations — Sprains. 

INDEX 280 



LIST OF ILLUSTRATIONS 



I. — The skeleton .... 

2. — Biceps at rest .... 

3. — Biceps contracted 

4. — Human red blood corpuscles and two white 
corpuscles .... 

5. — The heart and large blood-vessels 

6. — Diagram showing course of the blood through 
the heart .... 

7. — Showing the relative position of heart and 
lungs in the cavity of the chest . 

8. — The jaws and the teeth .... 

9. — Salivary glands 

10. — The stomach 

II. — Position of abdominal contents . 

12. — Under surface of the liver, showing the gall 

bladder and a section of blood-vessels . 
13. — The pancreas .... 
14. — Vertical section of a kidney 
15. — Section of skin greatly magnified 
16. — The cerebrospinal system of nerves 
17. — Side view of the brain 
18. — Under surface of brain 
19. — The mosquito: female 
20. — Manner in which the eggs of the Culex pipiens 

or common house mosquito, are deposited 
21. — Eggs of the anopheles .... 
22. — The mosquito larva . 



7 

16 
16 

19 
29 

30 

33 
37 
38 
41 
43 

45 
46 
48 

51 

54 

55 

56 

205 

207 
208 
209 



xiv LIST OF ILLUSTRATIONS 

riGURE PAGE 

2^. — Position of larva of common mosquito in ob- 
taining air 2IO 

24. — Position of anopheles larva in obtaining air • 210 

25. — Pupa. (Smith.) 211 

26, — Culex pipiens, or common house mosquito, 

female 212 

2y, — Anopheles, or malarial mosquito, female . . 213 

28. — Stegomyia, or yellov^ fever mosquito, female . 215 
29. — Culex sollicitans. Salt water sv^amp, or 

striped-legged mosquito 219 

30. — Diagram showing the position of the important 

arteries 244 

31. — Artificial respiration: inspiration. Pressure off 255 

^2, — Artificial respiration: expiration. Pressure on 255 



GOOD HEALTH 



GOOD HEALTH 



CHAPTER I 

THE STRUCTURE OF THE BODY 

The owner and master of a human body cannot 
hope to manage it properly, secure and maintain its 
usefulness and enjoyment, safeguard it in the diverse 
struggles of life and occupation, and protect it against 
sickness and disease without some precise knowledge 
of its construction and the various things which its 
organs are made to do. 

Some glimpses in brief of the strvicture and func- 
tion of the body will therefore fittingly introduce a 
book designed to foster in direct and practical fash- 
ion the welfare of its readers. 

THE SKELETON 

In the study of this subject it is proper that we 
should begin with an examination of the skeleton, 
for this constitutes the framework of the body and 
supports and protects the various organs which are 
found within the several cavities formed by the struc- 
tures. In order to perform these functions, the skele- 
ton must be composed of a hard and unyielding ma- 
terial which retains its shape, but it must have at the 
same time a certain desrrcc of elasticitv. For these 



2 GOOD HEALTH 

reasons the skeleton is constructed of bone, and it will 
be of interest to learn something of the composition 
and peculiarities of this substance. 

Bone consists of animal and earthy matter. The 
former is chiefly a substance which is converted by 
boiling into gelatin. It also contains fat and blood- 
vessels. The animal tissue in bone makes it tough 
and elastic, while the earthy matter, known as ''bone 
earth," consisting principally of phosphate of lime, 
furnishes the required hardness. 

In very early life the animal matter forms about 
one-third and the earthy matter two-thirds of bone; 
later in life, the proportion of lime is somewhat in- 
creased in amount, and the bone becomes denser. 
This explains why the bones of children are more 
elastic than those of adults. When considerable 
force is used a child's bone is apt to bend like a 
green stick, rather than break through, as in the case 
of adult bone. 

Rickets is a disease of childhood, and is due chiefly 
to an insufficient amount of earthy matter. In this 
condition the bones, for want of hardness, become 
bent and distorted, the deformity being particularly 
marked in the bones of the lower extremity which, 
for the time being at least, are unable to support the 
weight of the body properly. 

Bone is composed of compact and cancellated tis- 
sue. The former consists largely of earthy matter 
and is exceedingly dense and hard like ivory. The 
latter is a network of thin plates or columns and is 
sponge-like in appearance. The compact tissue forms 



THE STRUCTURE OF THE BODY 5 

the outer portions of bone and is increased in amount 
where great strength is required, as in the shaft of the 
femur or thigh bone. The cancellated tissue is par- 
ticularly abundant, where bones become enlarged in 
order to form joints, as in the ends of the long bones. 
Although cancellated tissue is very light, it is also 
very strong ; a portion corresponding in size and shape 
to a piece of loaf or lump sugar will support a weight 
of three or four hundred pounds. A piece of com- 
pact tissue an inch square and half an inch in thick- 
ness will support a weight of five thousand pounds. 
In formation of the skull, where great strength is 
necessary to protect the brain, the bone is composed 
of two layers of compact tissue with a small amount 
of cancellated tissue between. 

The long bones are hollow for the same reason that 
tubular columns are used in constructing a building — 
to secure strength with the minimum weight. The 
hollow part or canal in the shaft of long bones, as well 
as cancellated tissue, contains a substance called 
marrow or oil of bone. In the canals this substance 
is known as yellozv marrozv, and is composed almost 
entirely of fat. That found in the cancellated or 
spongy tissue of bone and known as red niarrozi' is 
three-fourths composed of water and contains but a 
small amount of fat. In very early life all the mar- 
row of bone is of the red kind. It is now known that 
all of the red corpuscles and some of the white cor- 
puscles, or leukocytes, of the blood, which will be 
referred to again later, are formed in the red marrow 
of bone. In addition, the yellow marrow has some- 



4 GOOD HEALTH 

thing to do with the nourishment of the tissues, par- 
ticularly in emergencies. 

The canals in the bones of birds communicate with 
the lungs, and contain air instead of marrow, thus 
rendering them very light and properly adapted to 
flight. 

Bone is supplied with nutrition from two sources : 
the periosteum and the nutrient arteries. 

The periosteum is a firm and resisting fibrous mem- 
brane, pinkish in color and closely adherent to the 
bone. It covers it at all points except at the ends 
where joints are formed and where cartilage exists. 
In the substance of periosteum are found blood-ves- 
sels which divide and subdivide and pass into minute 
openings in the compact tissue of bone to supply its 
outer surface with nutrition. When the periosteum is 
detached from- a bone, either by accident or other- 
wise, the compact tissue is deprived of its principal 
means of nutrition, and death or ''necrosis'' — corre- 
sponding to '"gangrene" in the soft tissues — follows. 
The nutrient arteries supply the interior of the bone 
with nourishment. 

Bones are also supplied with nerves and absorbents 
or lymphatics. The power of absorption possessed 
by the latter is so great that ivory pegs employed to 
hold in place the broken ends of bone unable to unite 
by natural processes, have been absorbed. 

The shape of a bone depends largely upon its use. 
The long bones, of which the femur or thigh bone is 
a type, are not only used for support, but act as 
levers to lift or move the various parts of the body 



THE STRUCTURE OF THE BODY 5 

through muscular attachment. They are composed of 
a shaft and two extremities. The short bones are 
found where a number of joints are required for Hm- 
ited motion combined with strength — for instance, the 
carpus or wrist. Flat bones aid in the construction of 
cavities, help to protect their contents, and provide 
for muscular attachment, as the bones of the skull 
and shoulder blades. Examples of irregular bones 
are the superior and inferior maxillary bones, or the 
upper and lower jaw, and the vertebrae or bones 
forming the spine. 

The skeleton, which is composed of two hundred 
bones, not including some small ones in the ear, is 
the framework of the body; it supports the soft tis- 
sues, protects the internal organs, and serves for the 
attachment of muscles. It consists of a central col- 
umn or spine, four extremities — two upper and two 
lower — and three bony cavities, namely, the cranium 
or skull, containing the brain, the thorax or chest, 
enclosing the heart and lungs, and the pelvis or basin, 
holding the pelvic and some of the abdominal or- 
gans. The arrangement of the bones is as follows : 

Spine 26 

Skull 22 

Hyoid bone I 

Sternum i 

Ribs" 24 

Upper extremities 64 

Lower extremities 62 



6 GOOD HEALTH 

The spine or backbone, which is about one-third 
the length of the body, is an articulated column com- 
posed of a number of bones (vertebrae) joined to- 
gether and forming three slight curves which aid in 
the formation of cavities for the protection of in- 
ternal organs. These curves also add strength to the 
column and go far to diminish shocks to the spinal cord 
and brain which might occur if the column were 
straight. The spine supports the skull and its contents 
and protects the spinal cord, which is contained in a 
canal formed by the union of the vertebrae. The spinal 
column rests upon the posterior and upper portions of 
the pelvis. 

The freest movement of the spine is found in the 
neck or cervical region, and the least in the back be- 
tween the shoulders where the ribs are connected with 
the spine. The weakest part of the spine is at its 
lowest part where the column is very movable. 

The skull is for the lodgment and protection of the 
brain and its membranes, blood-vessels and nerves. In 
very early life bone is not hard but is somewhat simi- 
lar in consistence to cartilage. The fontanelles, or 
^'soft spots,'' on an infant's head represent bones 
which have not become hardened or ossified, or 
brought closely and firmly together by this process. 
This condition usually disappears after the child is a 
year or so old. At birth and for some time after- 
wards even the long bones are not sufficiently hard 
or dense to be capable of supporting the body; and 
for this reason infants should not be placed on their 
feet too early. 




Fig. 



-The skeleton. 
7 



8 GOOD HEALTH 

A large opening exists at the base of the skull called 
the foramen magnum, through which the spinal cord 
passes from the brain to the canal in the vertebral 
column. Other and smaller openings are found in 
the skull for the passage of blood-vessels and nerves. 

The hyoid hone is a small and somewhat horse- 
shoe shaped bone found above the ^'Adam's apple.'^ 
It helps to support the tongue and also furnishes at- 
tachment for muscles. 

The sternum or breast bone is flat and narrow, about 
seven inches long, and may be easily felt under the 
skin in the front and upper part of the chest. It 
supports the clavicles, or collar bones, and the front 
end of the ribs with the exception of the last two. 

There are twenty-four ribs, twelve on each side, 
being numbered from above downwards. All of them 
articulate or join in the back with the vertebrae or 
spinal column, and in the front the upper ten con- 
nect through the medium of cartilage with the ster- 
num. The two lower ribs, the eleventh and the 
twelfth, are connected only with the spinal column 
behind, and are known as ^'floating ribs.'' These are 
rarely broken, for when struck or rested upon, they 
sink inwards because they have but one attachment, 
and usually escape injury. 

The peculiar arrangement of the ribs renders them 
very important agents of respiration, for when they 
are elevated by muscular action during inspiration, 
the chest becomes enlarged and the air passes readily 
into the lungs. In expiration the ribs are depressed, 
the chest cavity is diminished in size, and the air in the 



THE STRUCTURE OF THE BODY 9 

lungs is expelled. The diaphragm, which will be re- 
ferred to again later on, plays an even more important 
part than the ribs in connection with respiration. 

Each upper extremity is composed of thirty-two 
bones, named as follows : scapula or shoulder blade; 
clavicle or collar bone ; humerus or arm bone ; ulna 
and radius, the bones of the forearm; eight carpal 
bones, composing the wrist; five metacarpal bones, 
forming the framework of the palm and back of the 
hand, and fourteen phalanges or bones composing the 
fingers and thumbs. 

The scapula is a thin, flat, triangular bone, situated 
at the upper part of the back. It joins the clavicle and 
humerus at its outer end or border. It helps to pro- 
tect the contents of the chest and forms a broad sur- 
face for the attachment of muscles. 

The clavicle is shaped somewhat like the italic letter s, 
and may be easily felt as the upper and most super- 
ficial bone at the base of the neck in front. It extends 
from the sternum to a process on the outer portion of 
the shoulder blade; it holds the latter upward, back- 
ward and outward. 

The humerus is the longest and strongest bone of 
the upper extremity. It has a shaft and two extremi- 
ties, the upper one being received in a cup-like depres- 
sion in the outer part of the shoulder blade. The 
humerus has a greater range of motion than any other 
bone in the body, and is most often removed from its 
position and dislocated. 

The ulna and radius compose the forearm ; the ulna 
with the humerus forms the elbow-joint. The upjx^r 



10 GOOD HEALTH 

end of the radius does not take part in this joint or 
articulation. It is attached by ligaments to the outer 
side of the ulna, over which it freely glides or rotates, 
allowing the hand to move inwards and outwards. 
Its lower end, which is comparatively broad, takes 
part in the formation of the wrist- joint. The ulna 
takes no part in this articulation. 

The carpus or wrist is composed of eight small 
irregular bones arranged in two rows. This arrange- 
ment insures strength, motion and elasticity. 

The metacarpus consists of five long bones con- 
necting the wrist with the bones of the fingers and 
thumb, and forms the framework of the palm and 
back of the hand, where they may be easily identified. 

The phalanges, which are miniature long bones, are 
fourteen in number : three for each finger and two for 
the thumb. ' Their position may be easily demon- 
strated by bending or flexing the fingers. This ar- 
rangement is such that when the hand is opened, the 
fingers do not correspond in length; but when closed, 
as in grasping an object, there is no apparent differ- 
ence. This is necessary, for if the fingers when closed 
were uneven, the grasping power of the hand would 
be diminished. 

Each lower extremity consists of thirty-one bones, 
one less than in the upper extremities. They are as 
follows : the haunch or pelvic bone ; the femur or 
thigh bone ; the tibia, leg or shin bone ; and the fibula 
or splint bone; the tarsal bones (seven) or instep; the 
metatarsal bones (five) or ankle; the phalanges or 
toes, and the patella or knee cap. 



THE STRUCTURE OF THE BODY ii 

The pelvis is composed of the haunch bones and 
two smaller ones which join them behind, the sacrum 
and coccyx, constituting the lower portions of the ver- 
tebral column. The pelvis supports the trunk of the 
body and protects the pelvic and some of the abdom- 
inal organs. 

The femur is the strongest and longest bone in the 
body. Its length is characteristic of the human skele- 
ton. In the erect position of man, the tips of the 
fingers reach to about the middle of the thigh, while 
in the orang-outang, the fingers reach to the ankle. 
This difference is also due to the comparative short- 
ness of the arms in the human skeleton. The upper 
end of the femur is composed of a spherical head 
which connects obliquely with the shaft of the bone 
by a long neck. The function of the latter is to keep 
the thigh bone a proper distance from the pelvis and 
to prevent interference with locomotion. This round 
head rests in a depression or socket in the pelvis. 
The lower end of the femur is very large and broad, 
and articulates with the upper extremity of the tibia 
and, with the patella, or knee cap, forms the joint. 

The tibia or shin bone and fibula or splint bone 
form the leg. The tibia, which is very superficial, 
having only the skin as a cover, is the larger of these 
two bones, and is constructed mainly for strength and 
support, although some muscles are attached to it. 
The fibula, companion bone of the tibia, is external to 
it and very slim. It aids in supporting the tibia, takes 
part in the formation of the ankle-joint, and furnishes 
attachment for a number of muscles. 



12 GOOD HEALTH 

The tarsus, or instep, corresponds to the carpus, or 
wrist, in the upper extremities ; it consists of seven 
bones, while eight bones form the wrist. The tarsal 
bones, which form the arch of the foot, possess great 
strength; this is necessary to support the weight of 
the body. If the ligaments and other tissues which 
hold the bones of the tarsus together, particularly 
underneath, become relaxed, tofn, or otherwise dis- 
abled, the instep sinks, the arch of the foot is more 
or less destroyed, and what is known as ''flat foot'' or 
"broken arch" occurs. This not infrequently follows 
certain diseases of the bone. Some people are natu- 
rally flat-footed. 

The metatarsal bones of the foot correspond to the 
metacarpal bones of the hand and are the same in 
number. They form the framework of the foot. 

The phalanges are fourteen in number and corre- 
spond to the phalanges of the hand. 

The patella, or knee cap, is situated in front of the 
knee-joint. It lies in the tendon of a large muscle, 
and assists in the formation and protection of this 
joint. When the leg is extended and the muscle re- 
laxed, the patella will be found to be freely movable. 
Sometimes the little closed sack over the patella, the 
interior of which is moistened with a fluid to prevent 
friction, becomes injured and inflamed and very much 
increased in size, due to the presence of the fluid. 
This is known as ''house-maid's knee," for it is some- 
times produced by resting on the knees, as in the act 
of scrubbing. There are, however, other and probably 
more frequent causes for this affection. 



THE STRUCTURE OF THE BODY 13 

ARTICULATION— JOINTS 

Bones are connected at different points in the skele- 
ton; such a connection is called an articulation or 
joint. Some are immovable — those in the skull, for 
instance; others slightly movable, as the joints of the 
spine; while the greater number are freely movable, 
as the knee and shoulder joints and joints of the 
fingers and toes. 

Some joints have a gliding movement, as the wrist 
and instep. A ball and socket joint, where a globular 
head is received in a cup-like cavity, permits move- 
ment in several directions, as in the shoulder and hip. 
In a hinge joint the motion is limited to a forward and 
backward movement, as at the elbow and knee. 

The structures entering into the formation of joints 
are as follows : bone, cartilage, ligaments, tendons, 
synovial membranes, blood-vessels, and nerves. Bone 
has already been described. 

Cartilage, or ''gristle," covers the ends of bones 
which form joints. It acts as a buffer, protecting the 
adjacent bony surfaces from friction and prevent- 
ing shock which would occur if these surfaces were 
directly applied to each other. This is particularly 
noticeable in the vertebrae of the spinal column. 

The continual pressure brought to bear on cartilage 
would cause pain, inflammation and disease if it were 
supplied with blood-vessels and nerves ; consequently 
it is destitute of these structures, and is known as 
non-vascular tissue. It absorbs its nourishment 
from the surrounding parts by the process known as 



14 GOOD HEALTH 

imbibition. Cartilage is also found lining tubes, such 
as the air passages, ears and nose, where it is necessary 
that channels be kept permanently open. 

Continued pressure on cartilage diminishes its thick- 
ness, and during the day we may lose half an inch or 
so in height. However, rest and the recumbent posi- 
tion at night restore the cartilage to its proper thick- 
ness. Leaning too much on one side may cause a per- 
manent change in the cartilage, and consequent de- 
formity. 

Ligaments are composed of two kinds of tissue : 
white -fibrous and yellow elastic. The former are more 
common and connect the extremities of bones forming 
the joints. White fibrous tissue is very strong and 
flexible but it does not stretch; and while it permits 
the necessary movements of the joints, it does not al- 
low the articular ends of the bone forming the joint to 
become displaced. When a bone is dislocated, the 
ligaments, as a rule, are either ruptured or torn from 
their attachment. 

The ligaments composed of yellow elastic tissue 
are very elastic, and are found in parts where con- 
siderable range of motion is required, as in the cervi- 
cal region of the spinal column. This elasticity aids 
in returning the parts to their proper place after 
movement. 

Synovial membranes are delicate structures con- 
nected with the movable joints lining the inner side 
of ligaments ; but they do not extend between the 
articular surfaces of the bone. They secrete a thick, 
glairy fluid, resembling the white of egg, and known 



THE STRUCTURE OF THE BODY 15 

as synovia or "joint oil," the function of which is to 
lubricate the surfaces of the joint, and thus prevent 
friction. These membranes often become inflamed ; 
this condition is called ''synovitis." 

MUSCLES 

Muscles are bundles of reddish-brown fibers, having 
the power of contraction. There are two kinds : vol- 
untary or striped . muscles, and involuntary or un- 
striped muscles. The terms ''striped" and "unstriped" 
refer to the microscopical appearance of the individual 
fibers composing the muscles. 

The voluntary muscles are under the control of the 
will, and comprise the bulk of the muscular system. 
They are attached to the different parts of the skele- 
ton and act on the bones as levers ; they are agents 
of locomotion. They also protect the various struc- 
tures beneath them, and give grace and symmetry to 
the form. When the muscles are poorly developed or 
become diminished in size, a person becomes angular 
and bony. The lean meat of animals used for food 
is voluntary or striped muscular tissue. 

The voluntary muscles differ in length and shape, 
and are designated as long, short, broad, etc. They 
are arranged in pairs, for as a rule there are corre- 
sponding muscles on each side of the body. 

There are over four hundred muscles attached to 
the human frame. At many points their outlines are 
apparent to the eye, and are used by physicians as 
guides to the location of important vessels and nerves. 

Muscles are surrounded by thin wob-like tissue 



i6 



GOOD HEALTH 



known as fascia, which serves as a support and les- 
sens friction while the muscles are in action. 




Fig. 2. — Biceps at rest. 

Voluntary muscles are composed of a belly and two 
extremities. The more fixed extremity is called the 




Fig. 3. — Biceps contracted. 

origin, and the movable one the insertion, though in 
some muscles the origin and insertion are equally mov- 



THE STRUCTURE OF THE BODY 17 

able. During contraction the origin and insertion 
draw closer together, the muscle in action thereby 
becoming shorter and thicker. This can be easily dem- 
onstrated by raising a heavy weight with the hand, 
when the ''biceps/' the large muscle on the front 
of the upper arm, will be seen to thicken and bulge 
forward. 

Muscles gradually diminish in size towards their 
extremities. The fibers at this point are replaced by 
a firm and resisting substance composed of white 
fibrous tissue known as ''tendon." This is directly 
and intimately connected with the periosteum, and 
sometimes directly with the bone. Tendons differ in 
appearance from the muscular tissue in being white 
and glistening. An ''aponeurosis'' is simply an ex- 
panded tendon and is found where the muscle has a 
broad attachment. 

Muscles are abundantly provided with blood-vessels, 
nerves and lymphatics in order that there may be a 
constant supply of nourishment, that there may be 
a prompt response to stimulus from the nerv^e cen- 
ters, and also that waste matter may be absorbed. 
Tendons have but few blood-vessels, and only those 
of larger size have nerves. 

In the disease known as tetanus or "lock jaw,'' the 
nerve stimulus is so strong and the contraction of 
the muscles so powerful that fibers are sometimes rup- 
tured. The stiffness of the body which ensues after 
death, known as "rigor mortis," is due to the solidifi- 
cation of some of the fluid portions of the muscles : 
this again is followed within a few hours by the re- 



i8 GOOD HEALTH 

laxation of the body. It is believed that this rigidity 
is not so apt to occur in persons killed by light- 
ning. 

If muscles are not sufficiently used they become 
diminished in size and atrophy takes place. From 
continued non-use they may undergo degeneration, 
from which there is no recovery, for nature is not 
favorable to tissue which is of no use. Thus the 
value of exercise is apparent. Hypertrophy repre- 
sents the opposite condition to atrophy, and the mus- 
cles become increased in size. This is due to unusual 
and continued exercise and activity. The heart muscle 
becomes hypertrophied when it is necessary that this 
organ make up for the partial loss of function due to 
diseased valves. 

The involuntary or unstriped muscles, which are 
not under the control of the will, are not connected 
with bones, but form the muscular covering of some 
of the internal organs, as the stomach and intestines, 
and also the muscular coat of the blood-vessels. The 
contraction of this form of muscular fiber is not 
abrupt and rapid as in voluntary muscles, but slow, 
worm-like and unequal, and does not affect all portions 
of the muscles at the same time. The value of this 
during digestion will be referred to later. The invol- 
untary muscles have no tendons, the muscular fibers 
simply interlacing with each other. Although the 
heart is an involuntary muscle and not under the con- 
trol of the will, the fibers are striped in a manner 
somewhat similar to voluntary muscular fibers. This 
is the only instance of the kind. 



THE STRUCTURE OF THE BODY 19 

BLOOD 

Blood is the great nutritive fluid of the body; it 
distributes to the different tissues oxygen and nourish- 
ment necessary for their existence. If the system is 
not constantly supplied with oxygen, death quickly 




Fig. 4. — Human red blood corpuscles and two white corpuscles. 

follows, as in drowning. The blood has also the very 
important function of removing from the body through 
certain organs, principally the kidneys, lungs and skin,, 
worn out and waste matter which, if retained, may 
either seriously affect the health or prove fatal. 

Blood is composed of liquid and solid matter. 
The former is known as plasma and constitutes about 
two-thirds of the blood ; it is almost colorless when 
separated from the solid matter, or corpuscles. The 



20 GOOD HEALTH 

plasma contains the principal elements of nutrition 
which it distributes to the various tissues through the 
body, receiving in return waste matter to be discharged 
through the different excretory organs. 

The corpuscles or solid portion of the blood in the 
plasma are divided into red and white corpuscles, the 
latter being known as ''leukocytes." 

The red corpuscles are far more numerous and con- 
spicuous than the leukocytes or white corpuscles, and 
resemble in appearance a coin thinned in the center on 
b)Oth sides, or bi-concave. These little bodies are ex- 
ceedingly small, thirty-five hundred of them laid side 
by side on their flat surface being required to cover the 
space of an inch, and they of course are not visible to 
the naked eye. Physiologists have calculated that 
there are over fifty billion red corpuscles in the human 
body. When examined individually under the micro- 
scope they appear straw-colored, but when vast num- 
bers are crowded together, they present the charac- 
teristic red color. They are oxygen carriers. They re- 
ceive this gas from the air in the lungs and distribute 
it to the tissues throughout the system. 

The white corpuscles are much larger than the red 
ones, and are more globular in form. Until recent 
years the function of the white corpuscles was in 
doubt; now it is known that besides other uses they 
are extremely important agents in the destruction of 
bacteria or germs which find their way into the sys- 
tem. The leukocytes are most lusty fighters, and with 
the aid of the microscope may be seen actually to 
draw the infectious germs within themselves for the 



THE STRUCTURE OF THE BODY 21 

purpose of destruction. This exceedingly important 
and interesting function will be referred to again in 
a subsequent chapter. 

The amount of blood in the human body represents 
about one-twelfth of its weight. It is an alkaline 
fluid and heavier than water, having a specific gravity 
of 1055. 

Arterial blood, or that which has been purified in 
the lungs, is bright red owing to the presence of 
oxygen; while the venous blood, which is largely de- 
prived of oxygen and contains poisonous gas and 
waste matter, is of a bluish or purplish color. 

Some tissues, such as hair, cartilage and nai!s, are 
not supplied with blood, but receive their nutriment by 
their absorption or imbibition in a manner similar to 
cartilage. 

Coagulation, which occurs when a blood-vessel is 
opened, is nature's means of arresting hemorrhage. 
Coagulation sometimes takes place within vessels them- 
selves under certain abnormal conditions of the blood 
or vessels. 

In connection with the various subjects contained 
in this book reference will frequently be made to 
organs, glands, secretions, excretions, and mucous and 
serous membranes. For the sake of convenience 
these terms will be explained together. 

An organ is a part of the animal system having a 
definite function to perform ; for instance, the heart. 

A gland is also an organ, but in addition it either 
takes from the blood certain waste or poisonous mat- 
ter which it discharges from the body unchanged. 



22 GOOD HEALTH 

known as an excretion — as the urine — or it manu- 
factures from material removed from the blood a 
product which is found nowhere else and is employed 
in the body for a special purpose ; this is a secretion 
and the gastric juice is an example. 

Mucous and serous membranes are found in the 
interior of cavities, sacs and tubes. Mucous mem- 
branes line structures which open externally, such as 
the respiratory and alimentary tracts, while serous 
membranes cover the inner surface of cavities and 
tubes which are closed and have no communication 
with the outer world, such as the pleural and peri- 
cardial cavities. 



CHAPTER II 

THE VITAL processes: CIRCULATION, RESPIRATION, 
DIGESTION, NERVOUS SYSTEM AND LYMPHATIC SYSTEM. 

CIRCULATION 
Blood-Vessels 

In order that our bodies may be kept alive, there 
must be some form of transmission or circulation by 
which the various tissues are supplied uninterruptedly 
with nourishment. The need of that is not confined to 
human beings and animals, but applies to the lower 
forms of life as well as to plants and trees. The tree 
obtains its nourishment from the ground and trans- 
mits to its branches material to maintain their exist- 
ence and growth. A beautiful illustration of this may 
be found in the leaf in which the stem divides into 
many little ramifications for the distribution of nour- 
ishment. In the higher order of animal life nourish- 
ment is transmitted through the medium of blood, 
which is carried to every part of the system by tubes 
or blood-vessels. These are divided into arteries, 
capillaries and veins. 

Arteries are vessels which carry blood away fro]]t 
the heart. The aorta, which is the largest artery in 
the body and the beginning of the arterial system, is 



24 GOOD HEALTH 

connected with the left ventricle of the heart, and 
through it the blood passes to the various parts of the 
body. 

The walls of the arteries are composed of three 
coats or layers, namely, the external, middle and in- 
ternal coat. The external coat consists of white fibrous 
tissue which is very strong and tough and whose func- 
tion is protective. The strength and resistance of this 
coat are well exhibited when ligating or tying an 
artery, as surgeons are often obliged to do. The liga- 
ture is passed around the vessel and the ends drawn 
tightly together and tied for the purpose of closing 
the artery. This constriction usually severs the middle 
and internal coats, but leaves the external coat practi- 
cally intact or without serious injury. 

The middle coat of the arteries is composed of mus- 
cular and yellow elastic tissue which exerts a pressure 
upon the contents of the vessel and helps to regulate 
and force along the blood supply. The large amount 
of yellow elastic tissue in the arteries explains why 
the coats of these vessels are much thicker than those 
of the veins. It also accounts for the elasticity which 
is characteristic of arteries, and for the fact that 
arteries remain open when empty. The latter condi- 
tion gave rise in very early times to the belief that 
these vessels contained only air, and for this reason 
were named arteries or ''air carriers." 

Arteries pulsate, and when severed the blood es- 
capes in spurts and jets. This is due principally to the 
action of the heart and partly to the contraction of 
the arteries themselves. 



THE VITAL PROCESSES 25 

An artery in its normal condition may be likened 
to a rubber tube. If water is forced into a rubber tube 
it stretches a little to receive the fluid, and immediately 
contracts to its original caliber, thus aiding in forc- 
ing along its contents; this is elasticity. Time and 
exposure will render the rubber tube stiff, brittle and 
weakened. Under these conditions it is not elastic, 
and when force is applied within it may, under suffi- 
cient pressure, crack or break open with an escape of 
its contents. 

This is practically what occurs in so-called ''hard- 
ened'' arteries which frequently develop late in life. 
The middle coat containing the elastic and muscular 
tissue undergoes degeneration and becomes weak and 
brittle, and its elasticity largely disappears. When 
this occurs the smaller arteries particularly are often 
unable to resist the pressure of blood. The rupture 
of one of these little vessels in the brain giving rise to 
hemorrhage and pressure upon this organ causes pa- 
ralysis in some part of the body, known as apoplexy. 
A hemorrhage on one side of the brain causes paraly- 
sis on the opposite side of the body. The reason for 
this will be explained in the section relating to the 
nervous system. 

As arteries go farther into the tissue, they become 
exceedingly small and lose their external and middle 
layer, and have but one coat. They are then known 
as capillaries and become so minute that the red cor- 
puscles in order to pass through are sometimes obliged 
to ''double up" and pass one by one. The thinness of 
the capillary walls and the slow and uniform current 



26 GOOD HEALTH 

of blood in these vessels enable them, as already stated, 
to supply the tissues with oxygen and nourishment 
urgently needed, and to receive in exchange waste 
matter which is thrown out of the body by the excre- 
tory organs. 

The capillaries, after having supplied nourishment 
to the tissues and received waste matter in return, 
take on a second coat, and later still another one. 
These vessels, now having three coats, are known as 
veins. The middle coat contains but little of yellov/ 
elastic tissue, which accounts not only for the rela- 
tive thinness of the walls of these vessels com- 
pared with arteries, but also for the fact that they 
collapse when empty. Veins do not pulsate as arteries 
do, for they are further removed from the action of 
the heart; therefore, hemorrhage from a vein is a 
continuous flow rather than the spurt which occurs 
when an artery is severed. 

With the exception of those in the cranial, thoracic 
and abdominal cavities, veins are supplied with valves 
formed by a duplication or folding over of the in- 
ternal coat of these vessels; this allows the blood to 
flow in one direction only, towards the heart. These 
valves are very necessary, as the current of blood in 
the veins is mainly upward and against the force of 
gravity; moreover, the pressure of the blood in the 
veins is about only one-fourth of that in the arteries. 
Sometimes the valves become useless, and distention 
and distortion of the vessels occur. This is noticeable 
in the condition known as "varicose veins," which 
often occurs in the legs. 



THE VITAL PROCESSES 27 

The circulation of the blood throughout the body 
takes place in the following manner : The venous 
blood, containing worn out and waste matter and prac- 
tically deprived of oxygen, is collected throughout the 
body by two large veins which discharge their contents 
into the right auricle of the heart. The right auricle 
contracts and forces its contents into the right ven- 
tricle. The contraction of the ventricle follows. The 
valve guarding the opening between these two cavities 
closes, and the blood, unable to return to the auricle, 
is driven into a large blood-vessel which divides and 
carries the blood into the lungs. Upon reaching the 
lungs the veins grow smaller and exceedingly numer- 
ous, and at last become capillaries and surround the 
minute vesicles or pockets composing the lungs. Here 
a most important change takes place ; for it is at this 
point that the blood frees itself of carbonic acid gas 
and other waste and poisonous products collected 
throughout the system and receives in return oxygen 
from the air contained in the vesicles. The blood, 
now purified and enriched and in a condition to nour- 
ish the tissues of the body, is forced by the continuous 
action of the right side of the heart from the lungs 
into the left auricle. The latter then contracts and 
the blood passes into the left ventricle. The valve 
between these two cavities closes as it does on the right 
side, and the blood is driven into the aorta, the largest 
artery in the body. Thence it proceeds into the smaller 
arteries, and ultimately the capillaries where the in- 
terchange of nourishment and waste matter takes 
place. After performing this function, the capillaries 



28 GOOD HEALTH 

become continuous with the veins and the circulation 
is completed. 

Heart 

The heart is a pear-shaped muscular organ or pump, 
about the size of a closed fist of a man. The average 
adult heart is about five inches long, three inches 
through, and weighs from eight to twelve ounces. It 
occupies a position in the chest just behind the sternum, 
or breast-bone, and lies between the lungs mainly on 
the left side. The large end, or base, of the heart is 
above and points towards the right side, while the 
smaller end, or apex, is downward and to the left. 

A line drawn across the sternum or breast bone, at 
the upper border of the cartilage of the third rib in 
front, would indicate the base of the heart. The apex, 
or smaller end, of the heart is found between the fifth 
and sixth ribs and three and a half inches to the left 
of the middle line of the chest; at this point, the pulsa- 
tion of the heart can be distinctly felt. 

The heart is composed of four cavities or chambers: 
two auricles and two ventricles. The auricles are 
above and the ventricles below. Again, the heart may 
be divided into a right and left side, each having an 
auricle and ventricle. The ventricles do not connect 
with each other nor do the auricles, but an auricle 
connects with a ventricle of the corresponding side. 
The opening between the auricle and ventricle is 
guarded by a valve which is so arranged that the blood 
may pass from the auricle to the ventricle, but in nor- 
mal condition it cannot return. If this were not so 



THE VITAL PROCESSES 



29 



the circulation of the blood would be constantly inter- 
fered with. The ventricles are larger than the auricles 
and their muscular walls are much stronger, particu- 




FiG. 5. — The heart and large blood-vessels. A, right ventricle; B, 
left ventricle; C, right auricle; D, left auricle; E, aorta; F, 
pulmonary artery. 

larly those of the left ventricle, which must drive the 
blood received from the lungs throughout the entire 
system. The auricles contract together, as do the ven- 
tricles. 

Between the complete contraction of the ventricles 



30 



GOOD HEALTH 



and the beginning of the contraction of the auricles 
there is a pause which, although imperceptible, pro- 
vides a measure of rest for the heart — a very import- 
ant consideration. Otherwise the heart would be un- 
able to perform its function, for nature requires that 
all organs and tissues shall have a period of repose. 




Fig. 6. — Diagram showing course of the blood through the heart. 



This double action — the contraction of the auricles 
and ventricles — represents one pulsation of the heart. 
There are from sixty to eighty pulsations a minute. 
The heart is endowed with enormous power ; it is esti- 
mated that the energy exerted by this organ in 
twenty-four hours would raise a ton weight one hun- 
dred and twenty-five feet from the ground. 



THE VITAL PROCESSES 31 

The cavities of the heart are lined with a very deli- 
cate and smooth membrane knov^n as the endocardium. 
The endocardium is continuous throughout the whole 
system of blood-vessels, forming the internal coat or 
lining of the arteries and veins, and the only coat of 
the capillaries. The function of this lining membrane 
is largely to prevent friction. 

It is also necessary to protect the outside of the 
heart from contact. For this reason it is surrounded 
by a closed sac lined with a serous membrane called 
the pericardium. One side of this sac is attached to 
the walls of the heart; the other to the surrounding 
tissue. Below, considerable space is provided in which 
the lower portions, or apex, of the heart may move 
about. The interior of this sac is exceedingly smooth 
and contains a small amount of fluid ; this is very 
necessary as the constant action of the heart would 
otherwise excite friction. 

RESPIRATION 

Respiration is the act or process of breathing, and 
IS the means by which oxygen contained in the air and 
necessary to our existence reaches the blood for dis- 
tribution throughout the body, and is also the means 
by which poisonous gases and waste matter are thrown 
off from the blood. 

Respiration is divided into inspiration and expira- 
tion. The structures involved in this function are as 
follows: Mouth, nose, larynx, trachea, broiicliial tubes 
and the air vesicles or cells, of which the lungs are 



32 GOOD HEALTH 

chiefly composed. These different structures consti- 
tute the respiratory tract. 

A close examination of the throat will show two 
openings. The back, or posterior, one is the upper part 
of the esophagus or ''gullet.'' In front of this and just 
behind and below the base of the tongue, is the upper 
part of the larynx or ''wind-pipe." This consists of 
a cartilaginous box containing fibrous bands which 
stretch from the front backward, two on each side, 
one above the other. These are called vocal cords. 
The upper, or superior, pair have no special function 
known at present; the lower, inferior or true, vocal 
cords are extremely important, for it is their vibration 
during expiration, or when the air is expelled from the 
lungs, that produces the voice. 

The larynx may be easily located externally. The 
prominence known as "Adam's apple" in the neck 
forms its upper portion, the lower border being about 
one and a half inches below. The opening into the 
larynx is covered with a little leaf-shaped piece of 
cartilage known as the epiglottis, which aids in pre- 
venting food and other foreign substances from en- 
tering the wind-pipe. The tongue also aids in this 
protection, for in the act of swallowing, the base of the 
tongue is carried backward and partly covers the open- 
ing of the larynx. 

The trachea, or wind-pipe, is a continuation of the 
larnyx in the form of a tube about four or five inches 
long, and three-quarters of an inch to an inch in 
diameter. It is composed of rings of cartilage, fibrous 
membrane and a small amount of muscular fi'ssue. 



THE VITAL PROCESSES 33, 

These rings have the same function as the cartilage 
which forms the larnyx, i. e., to keep the walls sepa- 
rated or the tube open at all times. The trachea di- 
vides into two branches known as the right and left 
bronchi. 




Fig. 7. — Showing the relative position of heart and lungs in the 
cavity of the chest. 



Upon entering the lungs, the bronchi further divide 
and subdivide until the parts become exceedingly small 
and end in little pouches known as vesicles, or ''air 
cells.'' It is interesting to note that in the division of 
the trachea into two branches, the one on the right is 
somewhat larger than the one on the left and appears 



34 GOOD HEALTH 

to be the continuation of the trachea. It is for this 
reason that small articles accidentally sucked into the 
air passages are more often found in the right 
bronchus. 

The respiratory tract is lined throughout with mu- 
cous membrane which is kept moist and prevents fric- 
tion during the passage of air through the tube. The 
construction of this membrane in the upper portion is 
very peculiar and extremely interesting, for upon its 
surface are found little hair-like processes which are 
constantly waving towards the outer world. This is 
of valuable aid in preventing the entrance into the lungs 
of dust and other irritating particles. 

The lungs are two pyramidal-, cone- or triangular- 
shaped organs situated in the chest with the base be- 
low and longer behind than in front. Each lung 
weighs about twenty ounces, the right being a little 
heavier than the left. They are divided by deep fis- 
sures into lobes or sections, the right lung having three 
lobes and the left two. The small, or upper, portion 
or apex extends to, or just above, the clavicle or collar 
bone; the larger, or lower, portion or base descends 
in front to the sixth rib; the side to the eighth, and 
the back to the tenth. The lungs are surrounded by 
a closed sac lined with a serous membrane called 
the pleura, similar to the pericardium covering the 
heart and possessing the same functions, i. e., fur- 
nishing protection and preventing friction. This sac 
or membrane frequently becomes inflamed by dis- 
ease or accident: the condition is known as pleu- 
risy. 



THE VITAL PROCESSES 35; 

The lungs are composed of millions of minute 
pouches or air cells about one-two hundredths of an 
inch in diameter. They have already been referred to 
as the termination of the bronchial tubes. The enor- 
mous surface represented by these little pockets, which 
receive the air taken in with respiration, would, if 
spread out, cover an area df about six hundred square 
feet. The walls of the air cells and the capillaries 
surrounding them are so exceedingly thin that the 
interchange of gases and other products between the 
blood and the inspired air readily takes place. Under 
ordinary conditions we breathe from sixteen to twenty 
times each minute. 

During inspiration the air is carried into the lungs 
by the descent of the diaphragm, which exerts a 
suction force as it is carried downward, and also by 
the elevation of the ribs which increases the size of 
the chest. Expiration, or the expulsion of air from 
the lungs, is effected by the elevation of the diaphragm 
and the descent of the ribs and a partial collapse of 
the lung. Although these are the principal agents of 
expiration, there are other elements, notably the ac- 
tion of certain muscles which, although of lesser im- 
portance, render valuable aid when there is great diffi- 
culty in breathing, as in certain affections of the lungs. 
Then the action of muscles about the neck and shoul- 
ders becomes very apparent. 

The diaphragm is a muscular partition which sep- 
arates the contents of the chest from the abdominal 
organs. Above the diaphragm are found the heart and 
lungs, and below, the stomach, liver, intestines and 



36 GOOD HEALTH 

other abdominal contents. Its function is very im- 
portant both in connection with respiration and di- 
gestion. 

The lungs during life are never completely collapsed. 
Complete collapse is prevented by about one hundred 
cubic inches of air, which cannot be expelled, called 
''residual" air. Another hundred cubic inches known 
as ''reserve" air usually remain in the lungs after ex- 
piration, and are used during increased physical exer- 
tion as in running, rowing, etc. The "tidal" air repre- 
sents the amount taken into the lungs at each ordinary 
inspiration, and consists of about thirty cubic inches. 
During violent exercise, however, an additional hun- 
dred cubic inches may be taken into the lungs at each 
inspiration. This is known as "complemental" air. 
The extreme capacity of the lungs would therefore be 
the sum of the residual, reserve, tidal and comple- 
mental air, amounting to three hundred and thirty 
cubic inches. The vital, or respiratory, capacity, how- 
ever, is the amount which can be breathed out after 
the deepest possible expiration, and would therefore 
not include the residual air. 

DIGESTION 

The alimentary tract, or canal, comprises the several 
structures or organs through which food and drink 
enter the body to be digested and absorbed. 

The alimentary tract is nearly thirty feet long. It 
begins at the month and continues through the pharynx, 
or throat; the esophagus, or gullet; the stomach, and 
the small and large intestines, the latter terminating 



THE VITAL PROCESSES 



37 



These structures will 
from above down- 



at the external opening, or anus, 
be spoken of in their order 
wards. 

Mastication is the first step in digestion. This takes 
place in the mouth, the most important agents involved 




Fig. 8. — The jaws and the teeth, i, 2, incisors; 3, canines; 4, 5, 
bicuspids; 6, 7, 8, molars; a, vein; bj artery; c, nerve; d, vein, 
artery, and nerve. 



being the teeth. In man these are so fashioned and 
arranged that food may be cut, torn and ground, the 
teeth for each process being respectively incisors, 
canines and molars, or grinders. Their formation 



38 



GOOD HEALTH 



shows that man is adapted to all sorts of food. Among 
the animals, the cow, for instance, which obtains its 
food principally by grazing, has well developed molars 
or grinders ; while dogs, or animals that depend prin- 
cipally upon meat for sustenance, have sharp or tusk- 




FiG. 9. — Salivary glands. 



like teeth called ''canines,'' which enable them to tear 
meat from the bone. 

The teeth are inserted along the edges of the alveolar 
processes of the superior and inferior maxillary bones, 
or upper and lower jaw bones. There are thirty-two 
teeth in all, sixteen in each jaw, arranged as shown in 
the diagram (Fig. 8). The portion of a tooth pro- 
jecting beyond the gum is called the crown ; the rest is 
imbedded in the bone. The crown is covered with 



THE VITAL PROCESSES 39 

enamel, the hardest structure of the body, which pro-^ 
tects the teeth against various destructive agents and 
prevents too rapid wear as the result of friction dur-^ 
ing mastication. 

The teeth cut and grind the food so that all parts 
of it can be exposed to the digestive fluid. When food 
is introduced into the mouth, it is made soft and wet 
by an alkaline secretion known as saliva or ^'spittle" 
which is secreted by three glands, the parotid, the 
submaxillary and the sublingual, which discharge their 
contents into the mouth through small ducts or tubes. 
The flow of saliva may be stimulated by the anticipa- 
tion of palatable food, i. e., through a mental influence. 
The parotid, the largest of the three glands, is situated 
behind the angle of the jaw. The characteristic de- 
formity or swelling below and in front of the ears in 
the disease known as ''mumps,'' is due to the enlarge- 
ment of these glands. The secretion of the parotid 
accomplishes mainly the moistening of the food; the 
submaxillary and sublingual secretion is more viscid 
or '"slippery" and greatly facilitates the passage of the 
food downwards. In reptiles where there is no mas- 
tication, it is this slimy secretion that enables them to 
swallow substances of a very large bulk; by this means 
a comparatively small snake is able to swallow a good- 
sized rat. Saliva also renders important aid in diges- 
tion by changing starch into sugar, the form in which 
it is taken into the system. 

If food is not properly masticated the digestive ap- 
paratus sooner or later is sure to suffer, and indirectly, 
serious results may follow. Therefore, the importance 



40 GOOD HEALTH 

of giving proper and early care to the teeth cannot be 
overestimated. 

The pharynx, or throat, is a continuation of the 
mouth and has no special digestive action. 

The esophagus, or gullet, is a muscular tube about 
eight or nine inches long which is collapsed when not 
functioning. It begins at the lower border of the phar- 
ynx and passes downward through an opening in the 
diaphragm and becomes continuous with the upper, or 
cardiac, end of the stomach. This tube accelerates by 
its muscular action the passage of food downward to 
the stomach. Were it not for its muscular coat, swal- 
lowing, or deglutition, would be practically impossible. 
Difficulty in this direction sometimes occurs when the 
nerve supply in this tissue is interfered with. When 
one eats too rapidly, particularly of food which is dry 
and has not been properly masticated, it is difficult for 
the esophagus for the moment to force the food down- 
ward. The common phrase, ''stuck in the throat/' in- 
dicates the discomfort which occurs in this condition. 
For many reasons it is necessary that we should eat 
slowly and thoroughly masticate our food. 

The stomach is one of the principal organs of diges- 
tion. It resembles a bag-pipe in appearance, having a 
greater and lesser curvature. It lies crosswise in the 
abdominal cavity below the diaphragm, but when dis- 
tended with food, its position is materially changed. 
It has two openings, one on the left side continuous 
with the lower end of the esophagus already referred 
to, and called the cardiac opening from its proximity 
to the heart, and the other on the right side connected 



THE VITAL PROCESSES 41 

with the small intestines. This opening is guarded by 
a valve-like constriction called the pylorus or ''gate 
keeper," which aids in preventing food from return- 
ing to the stomach, although in certain conditions this 
m.ay occur. 

The stomach is ten to twelve inches long, about five 
inches in diameter and weighs something over four 




Fig. 10. — The stomach. 

ounces. Its capacity is from five to eight pints. In 
a newborn child it holds about one ounce. The stom- 
ach is composed of three coats or layers : the external, 
Hbroserous ; the middle, muscular; and the internal, 
mucous coat. The external covering supplies strength 
and prevents friction during the movement of the 
stomach. The muscular coat, composed of involun- 
tary muscle fibers, furnishes the movement neces- 
sary for the proper digestion of food, for it manipu- 
lates the stomach so that the food may be freely ex- 
posed to the gastric juice. The internal coat, or 



42 GOOD HEALTH 

mucous membrane, is the most important layer of the 
stomach, for in the substance of this membrane are 
found innumerable little glands which open upon its 
surface. These are known as ''peptic'' or "gastric'' 
glands, and secrete the gastric juice necessary to di- 
gestion. When food enters the stomach, or even at 
the beginning of mastication, the contents of these 
glands appear on the surface of the membrane, and 
the muscular coat begins its slow and worm-like con- 
traction to bring the food into contact with this secre- 
tion. The food is then changed in character and be- 
comes a uniform mass, some of which is absorbed by 
the capillary blood-vessels of the stomach; the greater 
part, however, passes into the small intestines for 
further digestion and absorption. 

The stomach is collapsible when empty, but when 
full lies against the abdominal walls and presses up- 
ward against the diaphragm, and in this manner often 
interferes with the action of the heart and lungs. The 
distress which commonly occurs after a full meal is 
usually due to this cause. 

The gastric juice, of which about fourteen pints are 
secreted in twenty-four hours, is an acid secretion, 
differing from all other digestive fluids, which are 
alkaline. 

The small intestine is also a very important organ 
of digestion. It begins at the pyloric, or right, ex- 
tremity of the stomach, and is a tube about twenty 
feet long and one inch in diameter and is composed of 
three coats similar to the stomach. Although there is 
no line of demarcation, anatomists have for certain 



THE VITAL PROCESSES 



43 



reasons divided the small intestine into three portions, 
the first, or duodenum, being the shortest portion — 




Fig. II. — Position of abdominal contents. 



about eight inches long. The second is called the 
jejunum, and the last portion is known as the ileum. 
The jejunum is generally empty after death and re- 
ceives its name from this fact. In the mucous mem- 



44 GOOD HEALTH 

brane of the intestine are found glands yielding an 
alkaline secretion which plays an exceedingly import- 
ant part in digestion. For instance, while meats are 
broken up and dissolved by the gastric juice, they are 
digested and absorbed in the small intestine. 

The large intestine is about five feiet long and twice 
the diameter of the small intestine. It begins on the 
right side of the body and is divided into three por- 
tions: the ascending, the transverse and the descend- 
ing colon. The lower part of the last is called the rec- 
tum and terminates at the external opening, or anus. 
The small intestine is continuous with the lower por- 
tion of the ascending colon. The digestive power of 
the large intestine is very feeble and unimportant; it 
is rather a temporary receptacle for undigested food 
and refuse matter which is to be discharged from the 
body. The transverse colon, which crosses the center 
of the abdomen about on the level with the navel, 
frequently becomes irritated by an accumulation of 
waste matter, and is the seat of intense pain known as 
"colic." 

The appendix, the inflammation of which, known as 
appendicitis, is familiar to the public, is a small tube 
about two or three inches long and about a quarter of 
an inch in diameter, given off from the lower end of the 
ascending colon. Its function is not known. 

The liver is the largest organ of the body. It is 
situated in the abdominal cavity below the diaphragm 
and above the stomach, principally on the right side, 
its longest diameter being from right to left. This 
organ, moderately filled with blood, weighs about four 



THE VITAL PROCESSES 



45 



pounds. The surfaces of the Hver are smooth and dark 
brown. In its normal healthy condition it extends 
downward on the right side as far as the lower border 
of the ribs. Under certain conditions, however, such 
as tight lacing, it may be pressed below this point. 




Fig. 12.— Under surface of the liver, showing the gall-bladder and a 
section of blood-vessels. 

The liver has three distinct and separate functions : 
First, it renders very important aid to digestion 
through a certain secretion known as bile. It also pro- 
duces sugar which subsequently becomes changed 
chemically and helps to generate the body heat. Finally 
it removes a small amount of waste matter from the 
system ; in other words, it excretes as well as secretes. 



46 



GOOD HEALTH 



The bile is discharged through a small tube into the 
first portion of the small intestine, the duodenum. 

On the under surface of the liver is found a pouch 
about four inches long and one inch in width, called 
the gall-bladder. This acts as a reservoir for the 
bile, the flow being continuous. 

The pancreas, or ''belly sweetbreads," compared 
with the liver is a very small gland, being about six 




Fig. 13. — ^The pancreas, partly cut away, so as to show the duct 
which collects the pancreatic juice and empties it into the duo- 
denum. 



inches long and one inch in thickness, but it has an 
exceedingly important function. It is located at the 
upper and back part of the abdominal cavity, mainly 
on the left side and behind the stomach. It secretes 
an alkaline fluid called the pancreatic juice, which is 
discharged through a small tube into the duodenum 
where the bile is also received, at which point these 
two important secretions act together. The chief 
function of the pancreatic juice is to prepare the oil 
and fat contained in the food for absorption by the 
process known as ''emulsification.'' During this trans- 



THE VITAL PROCESSES 47 

formation the oil and fat of the food are converted 
into a whitish fluid called ''chyle/' which is absorbed 
by the lymphatic vessels that follow along the intes- 
tinal tract. They are called lacteals, or milk carriers, 
on account of their color when filled with chyle. 
These empty into a pouch located in the lower part 
of the back, from which point the chyle is carried 
through a tube, the thoracic duct, to a large vein on 
the upper left side of the chest, and in this way 
reaches the circulation and forms a necessary element 
of nutrition. In addition to the above, the pancreatic 
juice has an all-round function in digestion, and as- 
sists other digestive fluids in their work. 

KIDNEYS 

The kidneys are excretory organs. They consist of 
two large, bean-shaped glands situated at the back of 
the abdominal cavity on each side of the spinal 
column, extending from the eleventh rib downward 
nearly to the upper portion of the pelvis, the right 
kidney being a little below the left. They are about 
four inches in length and two in width and weigh 
from four to six ounces each. 

The kidneys are constructed of tubes which may 
be called waste pipes, for their purpose is to drain off 
from the blood refuse and poisonous matter consisting 
largely of worn out tissue. The fluid excreted by 
these organs is known as urine, and consists of water 
holding in solution the various products just referred 
to, the principal one being known as urea. If this is 



48 



GOOD HEALTH 



not promptly removed from the body serious or fatal 
results follow. This usually occurs in the advanced 
stages of kidney disease. The amount of urine ordi- 
narily discharged from the body in twenty-four hours 
is about three pints, although this is subject to great 
change, depending upon climatic conditions and vari- 
ous organic and functional affections. 

The urine passes from the kidneys to the bladder 




Fig. 14. — Vertical section of a kidney, showing the minute tubes 
which excrete the urine; also the pelvis, or basin of the kidney, 
which receives the urine before it passes downward to the blad- 
der. The beginning of a ureter is also shown. 



THE VITAL PROCESSES 49 

through two small tubes, one for each kidney about 
the size of a goose-quill, and sixteen to eighteen inches 
long; these are known as ureters. Small concretions 
from the kidneys, popularly known as ''gravel,'' vary- 
ing in size from a grain of sand to larger dimensions, 
often pass through these tubes to the bladder, usually 
causing intense pain. 

The bladder or reservoir which receives the urine 
is situated in the lower part of the pelvic cavity in 
front, and is a sac or pouch having three coats or lay- 
ers similar to the layers of the stomach and intestines. 
When moderately distended the bladder is about five 
by three inches, and usually contains about one pint, 
although it may hold considerably more. The mus- 
cular coat, consisting of involuntary, or unstriped, 
muscle fibers, is the principal factor in expelling the 
urine, although this may be aided by the action of the 
powerful abdominal muscles which are under the con- 
trol of the will. 

SKIN 

The skin covers all portions of the body and pro- 
tects the deeper parts, and aids in giving grace and 
symmetry to the body. Like the liver, it is an organ 
of secretion and excretion, its principal function be- 
ing similar to that of the kidneys. It also contains the 
sense of touch, which is highly developed at the finger 
ends. Contrary to general behef, the power of ab- 
sorption through the unbroken skin of the human be- 
ing is extremely slight. 

The skin is composed of two layers, the outer and 



50 GOOD HEALTH 

inner. The outer is known as the epidermis, false or 
scarf skin ; the inner receiving the name of derma or 
true skin. The epidermis contains neither blood- 
vessels nor nerves, and is simply a scaly layer which 
protects the true skin underneath, and becomes easily 
detached from it under certain abnormal conditions. 
A sunburn will show the separation of these layers 
often with a small amount of fluid between them 
which constitutes a blister. The derma, or true skin, 
is richly supplied with blood-vessels and lymphatics. 

The true skin contains millions of minute suderif- 
erous, or sweat, glands, sebaceous, or fat, glands and 
hair follicles. The sweat glands, like the ducts in the 
kidneys, are constantly removing from the body a 
watery vapor known as perspiration or ''sweat," an 
excretion which by rapid evaporation from the sur- 
face has largely to do with the regulation — usually 
reduction — of the body temperature. This wonder- 
ful activity of the skin and the large quantity of per- 
spiration thrown off and rapidly evaporated enable 
one to endure a very high degree of heat. 

In addition to the action just described, the sweat 
glands eliminate from the system waste matter simi- 
lar to that excreted by the kidneys, chiefly urea. For 
this reason the skin is regarded somewhat as a sup- 
plementary organ to the kidneys, and they relieve each 
other. In warm weather when the skin is most ac- 
tive, the amount of perspiration is largely increased, 
and the amount of urine is correspondingly diminished, 
while in winter the condition is reversed. About two 
pints of perspiration is excreted in twenty-four hours 



THE VITAL PROCESSES 



51 



in temperate weather, although this may be largely 
increased, for it is subject to great variations depend- 
ing upon the outside temperature, exercise, etc. It is 
very important that the similarity of function of the 
skin and kidneys should be recognized, for when one 
is disabled, the other may to a certain extent perform 
its work. For instance, if the kidneys are impaired 
either temporarily or permanently, much relief may 
be obtained by stimulating the skin. Impairment of 
the function of either of these organs becomes a seri- 
ous matter if it is prolonged or if one does not quickly 
relieve the other. Physiologists have proven this by 
shaving and varnishing the skin of animals ; grave or 
fatal results soon follow. The importance of keeping 



Sweat pore 



Epidermis 




Oil glands 



Fat cell 



Hair bulb 



Blood-vessel ■ 

Fig. 15. — Section of skin greatly magnified. 



•52 GOOD HEALTH 

the skin and kidneys in a good healthy condition by 
a proper mode of living is apparent. 

The product of the fat, or sebaceous, glands which 
lie close to and discharge their contents into the hair 
sheath, or follicle, in the skin is a secretion. It pro- 
tects and keeps the skin, as well as the hair, in an oily 
and pliable condition. With few exceptions, the hair 
follicles cover the surface of the body, although in 
some portions it is so fine that it is hardly noticeable. 
The hair and nails are for the purpose of protection 
and are regarded as appendages of the skin ; they re- 
ceive their nourishment by absorption. 

The experience of '*hair standing on end'' is not 
entirely a fancy, for attached to the sheath, or folli- 
cle, which conducts the hair to the surface of the 
skin are involuntary muscle fibers which, when for- 
cibly contracted, raise the hair to a more erect posi- 
tion. This contraction may be brought about by men- 
tal stimulus, such as fright, etc. 

SPLEEN 

The spleen is a soft and spongy organ situated in 
the abdominal cavity on the left side near the stomach, 
and extends from the ninth to the eleventh rib. It 
measures about five inches long, three inches wide and 
two inches thick and weighs about eight ounces. It 
is called a ductless gland, not having the characteris- 
tic of either a secretory or excretory organ. Its func- 
tion has not yet been definitely settled, although it is 
not absolutely essential to life, for, as a surgical neces- 
sity, it has been removed from the body with recovery 



THE VITAL PROCESSES S3 

of the patient. Under certain conditions it becomes 
inflamed and enlarged ; for instance, in malaria the 
spleen becomes very much increased in size, and in 
sections of the world where this disease is prevalent 
the enlargement, which is quite apparent, is referred to 
as ''ague cake," the term ague meaning malarial fever. 

NERVOUS SYSTEM 

The activity of the mind and body, the harmonious 
working of the several organs, and the sympathy exist- 
ing between the different parts of the body depend 
upon the nervous system which is divided into the 
cerebrospinal axis, or central nervous system, and the 
sympathetic system. 

The cerebrospinal axis comprises the brain, the 
spinal cord and the nerves. 

The brain, which is the seat of the intellect, the will 
and the emotions, is contained in the cranial cavity. 
It is divided into four principal parts : the cerebrum, 
cerebellum, the pons Varolii and the medulla oblongata. 

The cerebrum constitutes about four-fifths of the 
entire brain. It is egg-shaped or oval in form and 
is divided into two portions by a deep groove running 
from the front backward. It is composed of gray mat- 
ter and white matter and is about the consistence of 
sweetbreads. The white matter forms the internal and 
greater portion of the cerebrum, the gray matter form- 
ing the external layer. The surface of the cerebrum is 
not smooth, but is thrown into deep folds called con- 
volutions ; this arrangement increases its area, and 
consequently its function. These convolutions are not 




Fig. 1 6. — The cerebrospinal system of nerves. 
54 



THE VITAL PROCESSES 



55 



well marked in the brain of an infant, but grow deeper 
and larger until this organ has practically reached its 
full development at about the fortieth year. The 
deep convolutions referred to are characteristic of the 




Fig. 17. — Side view of the brain. 



human brain; they are present in a far less degree in 
the lower animals. 

The cerebrum is the seat of the mind and its func- 
tions which distinguish man from the lower animal. 
The exact points in the cerebrum where these vari-- 
ous functions are located have not yet been fully 
determined, although there is no doubt that they are 
connected with the gray matter. 

The cerebellum, or little brain, corresponds in struc- 
ture closely to the cerebrum with which it is connected, 
being situated beneath it and at the back part of the 



56 



GOOD HEALTH 



cranial cavity. The cerebellum regulates and keeps 
in perfect harmony the different movements of the 
body, particularly the extremities. 




Cerebmiru 



Pons Varolii, 



Medulla 
oblongata. 



Cerebellum. 



Fig. i8.- 



-Under surface of brain, showing the cerebrum, cerebellum, 
pons Varolii, and medulla oblongata. 



The pons Varolii, or ''bridge/' is the small portion 
of the brain situated in front of the cerebellum; it 
binds together the different parts of the brain already 
enumerated, and also transmits the different nerves 
passing between the brain and the spinal cord. 



THE VITAL PROCESSES 57 

The medulla oblongata is beneath the pons Varolii, 
and appears to be the upper end of the spinal cord 
somewhat extended. In the substance of the inedulla, 
nerves which supply motion, passing from the brain 
to the spinal cord, cross each other, or decussate. Con- 
sequently, a motor nerve fiber having its origin in 
the right side of the brain crosses to the left when it 
reaches the medulla, and therefore becomes identified 
with the left side of the spinal cord from which point 
it supplies motion to the same side of the body. This 
will explain why a hemorrhage on one side of the 
brain will produce paralysis on the opposite side of 
the body, as in apoplexy. The medulla also presides 
over the function of respiration. 

The human brain weighs about fifty ounces, being 
heavier than that of any lower animal, with the ex- 
ception of the elephant and the whale. 

The spinal cord is that portion of the central ner- 
^rous system contained in the spinal or vertebral col- 
umn. The cord is cylindrical in shape, extending 
downward from the brain to the first lumbar vertebra ; 
it is from fifteen to eighteen inches long. Through its 
branches it transmits nerve impulses to and from the 
brain. It is to a certain extent capable of acting as a 
separate nerve center and generating force independ- 
ently of the brain, as far as motion and sensation are 
concerned, but not special sense. 

Nerves are classified as those having a motor in- 
fluence, those having sensory influence, and nerves of 
special sense. 

Motor nerves are fibers which conduct from the 



58 GOOD HEALTH 

brain, and to a certain extent from the spinal cord, the 
force necessary to animate muscular fiber, thus pro- 
ducing the different movements of the body. Motor 
nerves, therefore, transmit an influence from within 
outward. H we desire to walk, the mind wills that 
certain muscles shall be put into action ; this communi- 
cation is transmitted from the brain through the motor 
nerves in the spinal cord to the muscles. In the ordi- 
nary movement of the body we do not direct the ac- 
tion of each muscle, for this is done mechanically; 
but the mind starts and stops the machine and directs 
its course. 

Sensory nerves are fibers which convey sensations 
from the different portions of the body to the brain 
from without inward. For instance, when a finger is 
burned or injured, the sensation of the pain experi- 
enced indicates the impression made upon the sensory 
nerve at the point of injury and communicated to 
the great nerve center or brain. 

There are thirty-two nerves given off from each 
side of the spinal cord, forming thirty-two pairs. Each 
pair of nerves contains motor and sensory filaments or 
fibers which are distributed to the body to perform 
the function already described. 

Nerves of special sense, as the name implies, have 
a separate function from those referred to above. 
They do not transmit motion or common sensation, 
but preside over the special senses, such as sight, hear- 
ing, taste, etc. Twelve pairs of nerves are provided 
from the under surface, or base, of the brain for 
this purpose. 



THE VITAL PROCESSES 59 

The central nervous system controls the functions 
of animal life, the intellect, general sensation, motion 
and the special senses. There is still another system 
comprising the sympathetic nerves, which presides over 
secretions and excretions, the proper distribution of 
blood and nourishment to the tissues, the control of 
the involuntary muscle fibers in the alimentary 
tract, blood-vessels, stomach, bladder, etc. These must 
be unaffected by outer conditions. Were they sub- 
ject to the will and to the influence that governs the 
cerebrospinal axis, the functions of organic life would 
soon be disturbed and the most serious consequences 
would follow. This system must work uninterruptedly 
in health and disease both day and night and at all 
times. For this purpose, nature has supplied a sepa- 
rate and independent nerve force, the sympathetic, or 
ganglionic, system, consisting of a series of little bod- 
ies or ganglia which begin at the under surface of the 
brain and continue downward on each side of the 
spinal column to its lower extremity. Although this 
system is independent of the cerebrospinal axis and 
its special function, it communicates with and accom- 
panies the cranial and spinal nerves to the various 
organs. In this manner, the sympathetic system brings 
the different organs into sympathetic relation with each 
other. This relation will explain why a disordered 
stomach will produce headache and why death may 
follow a severe blow at the pit of the stomach. In the 
latter event the large sympathetic ganglion at the back 
of the stomach is injured and the shock conveyed to 
the heart is sufficient to arrest its action. 



6o GOOD HEALTH 

LYMPHATIC SYSTEM 

A description of the circulation and the means by 
which nourishment is suppHed to and waste matter re- 
moved from the body would be incomplete without 
a reference to the lymphatic or absorbent vessels. It 
has been stated in an early part of this chapter that the 
tissues are directly nourished by the minute capillaries 
which have an exceedingly thin coat through which 
the fluid portion of the blood containing sustenance 
readily escapes into the surrounding tissues. After 
the nourishment is extracted 'much fluid remains 
and were it not quickly removed the tissues would be 
overcharged with fluid and become ''soggy." It is 
true that the capillary blood-vessels reabsorb some 
of this liquid but only a small part of it; thereforr, 
some other agent for this purpose is necessary : This 
is the function of the lymphatic vessels. These ves- 
sels begin close to the capillaries and coming together 
form larger vessels which, with the exception of those 
draining the right arm and the right side of the face 
and neck, discharge their contents into a common 
trunk known as the thoracic duct. The thoracic duct 
lies in front of the vertebral column and, passing up- 
ward, discharges its contents into a large vein on the 
left side of the neck; this empties into the left auricle 
of the heart. The lymphatics from the right arm and 
right side of the face and neck empty into a cor- 
responding vein on the right side of the neck. 

There are two sets of lymphatics : a superficial one 
just under the skin, and one which drains the cavities 



THE VITAL PROCESSES 6i 

and deeper structures of the body. In the course of 
the lymphatics and intimately connected with them 
are found small bodies of varying sizes known as 
lymphatic glands. These have a very important func- 
tion ; they constitute a filter or trap which prevents the 
passage of infectious or poisonous matter into the 
system. In doing this they often become inflamed and 
enlarged and sometimes a surgical operation is neces- 
sary. The enlarged glands in the neck which accom- 
pany diphtheria or other throat affections are familiar 
to all. 

In describing the pancreas it was stated that the 
fats and oils taken with the food were emulsified by 
the pancreatic juice and transformed into a product 
resembling milk and known as *'chyle." This is also 
taken up by the intestinal lymphatics and carried to 
the thoracic duct and thence to the general circula- 
tion for nourishment. It will thus be seen that the 
principal function of the lymphatics is to return to 
the circulation fluid which was removed during the 
process of nourishment. 



CHAPTER III 



AIR 



We live in a sea of air or atmosphere which sur- 
rounds the earth to a depth of many miles. The com- 
position of this aeriform envelope was unknown until 
about the middle of the eighteenth century, when the 
researches of Joseph Priestley, an English chemist, led 
to the discovery that air consists chiefly of oxygen and 
nitrogen. It was subsequently found that a very small 
amount of carbon dioxid, commonly known as carbonic 
acid, forms part of the atmosphere. The following are 
the proportions: nitrogen, over 79 per cent; oxygen, 
over 20 per cent, and carbon dioxid, less than i per 
cent. These gases exist in the air as a mechanical, and 
not a chemical, compound. In addition, a varying 
amount of moisture is always found in the atmosphere. 

Air also contains impurities, either gases or solids, 
which differ in character and amount according to the 
locality, the purest air being found at sea and in the 
mountainous regions. 

The composition of air and the fact that the propor- 
tion of the gases which compose it is subject to very 
little change call for more than passing notice. It is 
with oxygen we are chiefly concerned, for of this we 
must have a constant supply to maintain our existence. 

62 



AIR 63 

Oxygen is far too stimulating to be used alone, for 
under this condition we would soon be worn out from 
overexcitement. Therefore, nature dilutes it with ni- 
trogen, a very bland and inactive gas. For this reason 
it is of great importance that the normal proportion of 
gases composing the air should remain undisturbed. 

Carbon dioxid is found even in the purest air. This 
gas is the result of innumerable forms of decay upon 
the earth's surface, and also within the earth. It is 
not injurious to health in the proportion in which it 
exists in good outside air, but when there is an exces- 
sive amount present, due to some form of contamina- 
tion, particularly within doors, unpleasant or serious 
results may follow. 

The moisture which is more or less constantly pres- 
ent in the air is due to the invisible vapor which rises 
from the great bodies of water upon the earth's sur- 
face and which returns in the form of mist, rain and 
snow. 

Through the respiratory tract the air reaches the 
lungs, where a vitally important interchange takes 
place. Here about one-fourth of the oxygen contained 
in the air entering the lungs is extracted for the pur- 
pose of enriching the blood, to renew the worn out 
tissue of the body and to produce heat. In exchange, 
carbon dioxid and other products representing waste 
matter are thrown off with the expired air. The inter- 
change referred to takes place in the minute air cells 
which have been described in the preceding chapter. 

In connection with this part of the subject it is very 
interesting to note that while animals absorb oxy- 



64 GOOD HEALTH 

gen and give off carbon dioxid as a waste product, 
plants depend upon carbon dioxid for their growth, 
and liberate oxygen. It is largely by this means that 
the proper proportions of these gases in the air are 
maintained. 

Impure air is found within and without the house. 
Outside the usual sources of contamination are the va- 
rious industrial occupations — particularly where coal is 
used in large quantities, the combustion of which gen- 
erates gases injurious to health — too closely con- 
structed buildings, narrow and filthy streets and vari- 
ous forms of decomposing matter. 

Nature goes far to neutralize these conditions by oxi- 
dation, by winds which rapidly displace or change the 
air and freshen it and by rains which wash or carry 
down all sorts of contamination. We recognize the 
improved condition of the air after a storm. Sunlight 
and vegetation are also important factors in securing 
this result. 

The law of diffusion of gases by which the latter mix 
with or work through each other is an exceedingly im- 
portant factor in our protection, for if it were not so, 
the heavier or poisonous gases would lie close to the 
surface of the earth, and our life would be very brief. 

Within a building the sources of impurities are the 
exhalations from the lungs, mouth and skin of those 
present, dust, filth, improper ventilation, bad plumb- 
ing and other insanitary conditions. In factories and 
mines there are, in addition to these impurities, prod- 
ucts arising from particles of coal, stone, metal, and 
poisonous gases, which are largely responsible for the 



AIR 65 

diseases commonly found among the workers in these 
places. Air is carried into the soil and when mixed 
there with decomposed organic matter, becomes un- 
healthful and offensive. Poisonous and inflammable 
gases are also generated beneath the surface and may 
be found at a considerable depth. When excavations 
are made, or during mining operations, they are fre- 
quently released and are not only detrimental to health, 
but when exposed to a flame or the oxygen of the air 
may cause explosions. Carburetted hydrogen or *'fire- 
damp" is an illustration. 

Contamination from underground sources is not in- 
frequently the cause of unhealthful and offensive cel- 
lars, for their walls, particularly those in the country, 
are often improperly constructed and may permit un- 
derground gases to pass through. These not only cause 
unpleasant odors, but are likely to contaminate milk 
and other foodstuffs which may be present. These 
gases may also permeate the house. 

It is not difficult to understand why those who work 
in mines or places where the air is contaminated are 
frequent victims of tuberculosis. In marked contrast 
to this is the fact that those who are most free from 
this disease are farmers and fishermen whose occupa- 
tions keep them constantly in the open air. 

There is a popular belief that impure air may be the 
origin of infectious diseases. This is not true. The 
danger of impure air lies in the fact that it lowers the 
resisting power of the body and renders it more sus- 
ceptible to disease. However, this only occurs where 
there is a long continued exposure to polluted air. 



66 GOOD HEALTH 

Modern sanitation has brought about a more serious 
realization of the necessity of pure air both to the sick 
and the well. Physicians have studied its importance 
in disease, and the windows of sickrooms are no longer 
kept closed. Certain affections, especially tuberculosis, 
are often treated in the open air with most satisfactory 
results, and medication in these instances has to a great 
extent been discarded. Sleeping in the open air is now 
a common practice and those who adopt it under proper 
and reasonable conditions discover its stimulating and 
invigorating effect. Fresh air is therefore a tonic both 
in health and sickness, and a powerful factor in com- 
bating disease. 

While we cannot expect to find absolutely pure air, 
for the air we breathe contains some form of contam- 
ination, we should seek for good fresh or moving air, 
and also remember that it is the maximum and not the 
minimum that is desired, and that this can only be 
found out of doors. The belief that night air is 
detrimental to health has little or no foundation. 

Ozone is a modified form of oxygen. Its existence 
in the lower stratum of atmosphere, except under spe- 
cial or local conditions, has not been definitely proved. 
It is generated during thunderstorms as the re- 
sult of the action of electricity in the air, and it is often 
present in the immediate vicinity of an electric appa- 
ratus. At these times it may be recognized by its 
peculiar odor, which somewhat resembles that of rub- 
ber. The popular notion that ozone is a great purifier 
has been responsible for many theories concerning its 
healing properties in connection with certain diseases. 



AIR (ij 

The fact that comparatively little investigation has 
been made in regard to the use of this gas for practical 
purposes furnishes meager information as to its pos- 
sibilities. Ozone is artificially produced by electricity 
for commercial and disinfecting purposes. It is a 
much more powerful oxidizer than oxygen. It 
bleaches, and is destructive to bacteria. 

The term humidity relates to the moisture contained 
in the air. Sometimes the amount is very great during 
the summer and goes far to increase the uncomfort- 
able and depressing effect of the hot weather. The 
regulation and cooling of the body temperature de- 
pends largely upon the proper evaporation of the wa- 
ter or perspiration discharged upon the surface of 
the skin. This takes place much more rapidly when 
the air is dry than when the air is very humid. , There- 
fore, if the atmosphere is well saturated with water,, 
less heat is given off from the body, and the physical 
effect is far more uncomfortable and oppressive. It 
is for this reason that high localities are sought for 
during the hot season, for in these places the humidity 
is usually lower and the air is correspondingly dry and 
bracing. 

Agitation of the air cools the body by causing more 
rapid evaporation from the skin. Therefore, electric 
fans used during the warm weather have a very grate- 
ful and beneficial effect, provided they are properly 
situated in the apartment and not too close to its oc- 
cupants. Otherwise, they may have the effect of 
drafts. 

A very important and interesting part of the sub- 



68 ^ GOOD HEALTH 

ject of atmosphere relates to its weight. The weight 
of the atmosphere is equivalent to about fifteen pounds' 
.pressure upon every square inch of surface at the level 
of the sea. This pressure has an important effect 
as far as the human body is concerned, for ,it main- 
tains the equiHbrium of the heart's action and the cir- 
culation of the blood. When a high altitude is reached 
this control is somewhat lessened as the weight of the 
air is diminished and the heart is apt to become dis- 
turbed and very small blood-vessels, particularly those 
in the mucous membrane of the air passages, frequent- 
ly burst. Nose bleed often takes place under these 
conditions. These occurrences are familiar to travelers 
who ascend lofty mountains, and are usually unattend- 
ed with danger, unless some serious organic disease of 
the heart or blood-vessels exists. It should be noted 
that this is not due to a change in the proportion of the 
gases composing the air, but to the lessened density of 
the atmosphere. 

The pressure of the air affects not only the earth's 
surface, but also every object upon the earth. There- 
fore a man of ordinary size probably sustains a weight 
of fifteen or sixteen tons. The question very naturally 
arises: Why are we not crushed by this enormous 
pressure? It is because it is equally distributed and 
because there is air in the tissues and cavities of the 
body which presses outward. These conditions bring 
about an adjustment, prevent interference with the 
various functions and render us unconscious of any 
pressure ; yet when the air is in rapid motion, as dur- 
ing windstorms, we can appreciate its force and power. 



CHAPTER IV 

WATER 

Chemically pure water consists of two volumes of 
hydrogen and one of oxygen. We do not drink pure 
water, for the natural supply always contains vari- 
ous salts as well as some form of .contamination. Some 
of these salts are necessary for our well-being, and the 
contamination which occurs in good healthful water, 
which may be termed practically pure, is so slight that 
it may be regarded as a negligible factor. The chief 
danger from potable water lies in the fact that it may 
contain infectious germs. 

Water, next to air, is most necessary to our ex- 
istence; without it we could live only a few days. It 
plays an exceedingly important part in maintaining the 
functions of the organs and tissues, and forms at least 
four-fifths of all the food we take. It is constantly 
needed to make up for the loss of moisture from the 
skin and lungs, and also aids in preserving the shape 
and symmetry of the body which is composed of sev- 
enty-five per cent of water. 

Water supplies life to plants and to all living things 
beneath its surface through the oxygen it contains. 
Fish removed from it quickly die of suffocation. Their 
respiratory apparatus cannot take oxygen from the air, 

69 



70 GOOD HEALTH 

although they abstract it from the water, which we 
are unable to do. A person who is submerged for 
more than four or five minutes is not usually resusci- 
tated. 

The ocean, which covers more than three-fourths 
of the surface of the globe, is the natural source of 
our water supply. From it arises, through the action 
of the sun's rays, a continuous invisible stream of va- 
por to the atmosphere. This is afterward condensed 
and precipitated in the form of mist, rain and snow. 
At least three-fourths of this returns directly to the 
ocean, while the part falling on the land forms rivers, 
lakes or pools or, penetrating into the earth, becomes 
the great underground system upon which we depend 
largely for drinking purposes. 

It is important to know something of the course 
taken by the water entering the ground and the vari- 
ous combinations it forms during its descent. A sec- 
tion of the earth will show the soil arranged in various 
layers or strata. The significance of this as indicating 
the formation and age of the earth is well known to 
the geologists. It is also of great interest in connection 
with the underground water system, for it explains 
the manner in which it is collected and distributed. 

The layers referred to are variously composed of 
sand, gravel, chalk, clay and other like substances. 
Some of these, clay for instance, are practically im- 
permeable, i. e., water cannot pass through them. On 
the other hand, sand is easily penetrated. Therefore, 
water in its descent passes without difficulty through 
the sand and upon reaching a layer of clay or some 



WATER 71 

other impermeable stratum is directed along until it 
finds an exit somewhere. This may occur in the form 
of a spring or as a supply to some body of water, or it 
may remain below until an outlet is made for it in 
the form of a well. 

The strata found at various levels are not uniformly 
arranged and are frequently curved, sometimes form- 
ing large underground basins. As a result, water upon 
entering the earth may reach an impermeable stratum 
at dififerent depths and supply superficial or deep wells. 

Innumerable forms of impurities are carried into 
the ground by the surface water. Many of these are 
filtered out by the soil; some are destroyed by oxida- 
tion, for air passes into the ground ; and some are de- 
stroyed by certain forms of bacteria or germs which 
live upon organic matter. For this reason water be- 
comes purer as it goes farther into the earth, and we 
may expect to find a better and safer water supply 
in a deep well than in a superficial one. 

Certain gases confined in the earth sometimes force 
underground waters to the surface, although this is 
usually brought about by the pressure of the water 
from behind in its eflforts to reach its own level. A 
supply frequently has its origin in mountainous regions, 
or where there is considerable elevation, and may 
follow along impermeable strata, sometimes to a con- 
siderable depth, and appear at the surface by natural 
or artificial agencies many miles away. 

Not infrequently heated water, which probably has 
its origin in the earth, reaches the surface and forms 
what are known as "hot springs.'' The various condi- 



72 GOOD HEALTH 

tions above referred to have led to the establishment 
of many celebrated resorts, water cures and springs 
throughout the world. 

Water is one of the most important of solvents, and 
during its transit through the earth, various chemical 
changes take place. The soil is rich in carbonic acid, 
and the underground water, holding this gas in solu- 
tion, dissolves out various mineral substances con- 
tained in the strata with which it comes in contact. In 
some instances, the presence of these salts is so pro- 
nounced that the water is unfit for general use, al- 
though in this condition it is sometimes employed for 
medicinal purposes. Water most frequently combines 
with lime and magnesia, particularly the former. When 
a comparatively large amount of it is present, the 
water becomes ''hard," i. e., the lime or magnesia com- 
bines with the fatty acids of soap and prevents the 
prompt formation of lather. For this reason, the hard 
water is neither satisfactory nor economical for bath- 
ing or domestic purposes. While it is believed by some 
that the long continued use of hard water for drink- 
ing purposes may cause certain affections, it is prob- 
able that there is little danger from this source pro- 
vided the water is not too hard, although it may not 
be as palatable as some other kind. Water which 
contains little or no lime is called ''soft'' and is better 
and pleasanter for general use. 

If it were possible to collect rain water above the 
point of contamination, it would be the purest and 
softest supply we could obtain ; but during its descent, 
some form of pollution always takes place, for it 



WATER 73 

washes out the air. In the country the contamination 
is comparatively slight, but in cities and manufacturing 
towns, where the air is constantly charged with poison- 
ous gases, products of offensive trades and the usual 
pollution of these places, the rain water, unless puri- 
fied, is usually unfit for drinking purposes. 

In regions where there is no general water supply 
to draw from, such as springs, rivers, lakes, etc., and 
where little can be secured from underground sources 
owing to the peculiar formation of the soil, rain water 
is carefully and eagerly collected. In emergencies it 
is often caught upon canvas or rubber cloths, and for 
general use large ground areas with cemented floors 
and underground storage cisterns are sometimes em- 
ployed. Although the more corhmon method is to col- 
lect it in receptacles as it runs from the roofs of build- 
ings. As a rule, little attention is given to the clean- 
liness of these surfaces, yet it is of great importance if 
the water is used for drinking purposes. A meas- 
ure of protection against contamination may be se- 
cured by having the waste pipe from the roof so 
constructed that it can be quickly disconnected from 
the storage tank or barrel at the beginning of the 
rain and allowed to discharge over the ground for a 
few minutes in order that the roof may be cleaned, 
and then reconnected with the receptacle. A high- 
pitched slate roof offers the best advantages so far as 
this form of rain water collection is concerned ; it is 
much easier to clean. 

Careful attention should be given to the construc- 
tion of storage tanks or cisterns. They should not be 



74 GOOD HEALTH 

made of lead, for rain or other soft water will dis- 
solve the metal and render the water unfit for drinking 
purposes. For the same reason lead pipes should not 
be used for the transmission of drinking water. Iron 
tanks may discolor the water and also make it un- 
pleasant for drinking. These tanks should be con- 
structed preferably of Portland cement, slate or enam- 
eled ware, which gives ofif no objectionable product 
and can be cleaned easily and promptly. Galvanized 
iron may be used, although it is inferior to the ma- 
terials just referred to. Wood is commonly used for 
the construction of storage tanks, particularly on the 
tops of buildings where it is necessary that the weight 
of these receptacles should be reduced to the mini- 
mum. The objection to it is that it rots and leaks, ab- 
sorbs unpleasant odors and cannot be properly cleaned. 
A storage tank should have an outlet at the bot- 
tom which will permit the free escape of its contents 
in order that it may be properly cleaned. For 
cleaning there is no better agent than a solution of 
soda and hot water applied with a long-handled brush ; 
the tank afterwards should be carefully rinsed out. 
The brush should be boiled in water for at least five 
minutes immediately preceding its use, to destroy any 
bacteria which may be present. If the tank is of a very 
large size, it is a common practice for the cleaner to 
go inside the receptacle. Infective material is in this 
way undoubtedly transmitted by the feet. If this 
method is employed the cleaner should wear rubber 
boots, which have just previously been heated in 
boiling water. 



WATER 75 

Underground tanks for the storage of water are to 
be condemned under all circumstances. If improperly 
constructed, they are not only liable to admit poison- 
ous gases from the surrounding soil, but are subject 
to all sorts of surface contamination. Besides, when 
not efficiently covered, small animals not infrequently 
fall into them and are drowned. Like all tanks, they 
are favorite breeding places for mosquitoes. Further- 
more, this class of tanks cannot be properly cleaned. 

The demand for modern methods of waste disposal 
in country homes, which is referred to later on, calls 
for the construction of storage tanks on the roof or 
in the top floor of the house. These should have a 
capacity of about five thousand gallons for drinking, 
flushing and other purposes. These tanks should be 
closed with a tight-fitting cover and ventilated by a 
pipe from the cover to the outside of the building, 
which should have a bend in order that foreign bodies 
cannot reach the contents of the tank. 

Rain water barrels found about country homes are 
usually in an unsanitary condition and imperfectly 
covered. They also serve as breeding places for mos- 
quitoes. This is so notorious that the common torm 
of this insect is known as the "rain-barreF' mosquito. 

Spring water is usually cold, sparkling and re- 
freshing, and therefore very palatable. Spring water 
may be quite free from impurities in the country, but 
in towns and cities there is always danger of contami- 
nation, for the water may come through superficial 
strata and receive impurities from the surface. When 
spring water is used, it should be protected against 



"je GOOD HEALTH 

contamination at its exit by a stone or cement walls 
and floor. In addition, a pipe may be introduced into 
the opening, not only for protection but to conduct the 
water more effectively to its exit. 

Lake water, particularly from the mountain slopes, 
furnishes a very satisfactory drinking supply, for it is 
relatively pure. The water is still and the organic 
matter and other forms of impurities which it contains 
easily settle to the bottom; moreover, oxidation goes 
far to destroy impurities on the surface. There is 
considerable truth in the saying that lakes clean them- 
selves. When this supply is used for drinking pur- 
poses, there should be the most rigid and constant con- 
trol to prevent the discharge of sewage or other 
forms of filth into the water, and the intake should be 
some distance from the shore to prevent still further 
the danger of contamination. The safety of this 
form of water supply must always be seriously ques- 
tioned if the border of the lake is inhabited. 

River water, which is often used as a general water 
supply, is very apt to be unfit to drink except at its 
head in mountains and tributaries which are not con- 
taminated, or before it receives the waste and sew- 
age of towns. The ease and economy with which 
municipalities can draw water from these sources have 
led to many serious results as far as general infection 
is concerned. 

River water used by large communities for drinking 
purposes is generally filtered or otherwise treated for 
the purpose of purification. The former method 
usually consists, in brief, of passing the water over 



WATER ^7 

filter beds composed of gravel on top of which is a 
layer of fine sand three or four feet in depth. Impuri- 
ties are removed as the water passes down through 
the permeable layers to its destination or receivers. If 
this method is properly carried out the intake is 
largely freed from bacteria and other forms of con- 
tamination. The important protective factor in this 
process is the sand, although a scum or layer, ex- 
tracted from the water, which forms on the top of 
the sand, also acts as a filter and is of value as a puri- 
fying agent. 

This means of purification, however, cannot be de- 
pended upon and river water for drinking purposes in 
inhabited regions is always a menace to the public 
health. The ancient Romans were aware of this, for 
although the River Tiber runs through the City of 
Rome, water was brought from distant sources by 
aqueducts so splendidly constructed that some por- 
tions are still in use. 

Well water is a common source of supply in this 
country, and, like spring water, is cool and pleasant to 
drink. Unfortunately, wells are frequently contami- 
nated, and in this way may convey infectious ma- 
terial; for instance, typhoid fever is sometimes trans- 
mitted by this means and partly explains why this dis- 
ease often occurs in rural districts. 

Deep wells are less dangerous as far as infection 
is concerned than superficial ones, for the water from 
the former is usually drawn from a deeper stratum; 
yet defective construction will allow surface impuri- 
ties to reach the interior of even deep wells throug;!! 



78 GOOD HEALTH 

their walls. Artesian wells constitute an exception 
to this, for they are sometimes bored to a depth of 
many hundred feet to reach below or between imper- 
meable strata where water is held under pressure. 
This escapes to the surface through a continuous pipe 
or tube which if properly constructed admits of but 
little danger from contamination, particularly if the 
exit is carefully protected. For this reason, arte- 
sian well water may often be used with safety in built- 
up communities, although in all instances they should 
be under the observation of health authorities. 

There is need of protection about the opening of 
an ordinary well, as the space immediately surrounding 
it is often a fruitful source of contamination, and for 
a distance of a few feet at least this should be graded 
and cemented from the edge of the wall outward and 
downward. The open or ''old oaken bucket'' system 
is anything but sanitary. In its place a modern pump- 
ing apparatus should be used so that the opening of 
the well can be closed and protected against pollution 
and the entrance of small animals. 

The ordinary dug well is cylindrical and is usually 
lined with brick or stone and cement. The safety of 
this means of water supply is greatly enhanced if the 
outside of the wall or structure of the well is tarred. 

As a well may receive infectious matter from a 
nearby broken drain or privy vault, cesspool or the 
like through the soil, it is necessary in addition to the 
proper construction that it be placed at the highest 
practicable point and as far as possible from all chance 
of pollution. A safe- distance cannot be arbitrarily 



WATER 79 

stated, for the danger of infection depends largely 
upon the arrangement of the underground strata. 
However, a well may be placed fairly out of harm's 
way by a careful study of the conditions already re- 
ferred to. The danger of contaminating a well from 
surface drainage is probably much exaggerated, 
yet it may occur where fissures or cracks exist in 
the grounds. 

It is a practice among those who frequently make 
short excursions into the country to drink clear cold 
well water whenever it can be found. This is un- 
safe, particularly where the wells are not in constant 
use. Water from this source should not be used for 
drinking purposes unless after careful inquiry and ob- 
servation there is reasonable evidence that it is not 
contaminated. Some form of infection might be the 
result of omitting this precaution. 

The ova, or eggs, of various parasites, such as the 
tapeworm, hookworm, and roundworm, which are ex- 
pelled from the intestinal tract, may reach a water 
supply. Not infrequently small streams or creeks, 
which furnish water cool and pleasant to drink, are 
contaminated through sewage which empties into 
them. Therefore, water from these streams should 
not be used for drinking purposes, nor should the wa- 
tercress or other vegetation which grows in them be 
eaten unless there is substantial proof that there is no 
pollution present. 

The need of water in the preservation of health is 
far from being appreciated and as a rule we do not 
drink enough of it. A lack of water often leads to 



8o GOOD HEALTH 

indigestion, torpidity, constipation, headache, dryness 
of the skin, etc. 

It is estimated that the adult human being requires 
about two quarts of water within the twenty- four 
hours. One-third of this is usually taken in with the 
food. "In addition, four or five glasses during the day 
under ordinary conditions would be a fair estimate 
of the amount required by the system. It is subject 
to great variations, depending largely upon exercise 
and climatic conditions, for during the warm weather 
the activity of the skin rapidly abstracts large quanti- 
ties of water from the body which should be promptly 
replaced. 

Contrary to the general belief, there is no objection 
to drinking a reasonable amount of water with meals, 
although it should not be confined to this time but 
distributed more evenly throughout the day. It is not 
harmful to drink moderately of iced water, particu- 
larly during the warm weather, for it aids in cooling 
the body. It may be added that horses under ordinary 
conditions drink about eight gallons of water daily 
and cattle somewhat less. 

The importance of water in maintaining health re- 
quires that the supply shall be as pure as possible. 
We shall learn as we go further into the subject that 
nature does not demand that what we eat and drink 
and the air we breathe shall be absolutely pure, for it 
is tolerant of a certain amount of adulteration. Some 
form of impurity almost always exists, particularly in 
municipal water supplies. The danger is not so much 
from ordinary contamination but rather from the 



WATER 8i 

presence of infectious germs which are not apparent 
from the appearance, for the clearest and apparently 
purest specimens of the water may contain germs of 
disease. 

It is reasonable to assume that if there is no marked 
prevalence of water-borne diseases, such as typhoid 
fever and dysentery, the general supply of a town or 
city may be drunk with safety. Reliable information 
regarding this matter may usually be obtained from 
the local health officer. 

It is a common practice, even in cities and towns 
where the safety of the general water supply has been 
reasonably established, to drink bottled waters for the 
alleged purpose of escaping infection. This practice 
not only inspires fear but is usually without justifica- 
tion and should not be resorted to unless in some 
special instance it is recommended by the municipal 
health authorities. Furthermore, there is doubt as 
to the purity of some of the bottled waters offered for 
sale. 

There are many methods proposed and innumerable 
types of water filters offered for sale for the clarifica- 
tion and purification of drinking water, chiefly for 
domestic purposes. A large percentage of these filters 
find their way to country homes in response to a 
demand for some appliance or means which will aft'ord 
protection against contaminated water. 

While not attempting to discuss the relative merits 
of the various filters, it may be said that some render 
very efficient aid in the purification of water, but 
a large proportion of them are practically worthless. 



S2 GOOD HEALTH 

Furthermore, the public does not as a rule seek proper 
advice in the selection of these apparatus, but are quite 
willing to accept the very plausible recommendation 
of their makers. 

The home practice of clarifying water by the use 
of alum, tea leaves, etc., is not entitled to considera- 
tion, for it is worse than useless. It suggests a pro- 
tection which is only imaginary, for these methods 
do not destroy infectious organisms which may exist 
in the water. 

In small communities and in the country where no 
properly organized health protection exists one should 
be particularly alert in guarding against impure drink- 
ing water. This may be done by carefully bearing in 
mind the way in which water supplies are collected 
.and the ordinary means of contamination. But fur- 
ther and still more important is the need of a periodical 
bacteriological examination of all drinking water which 
is not a part of a general or common supply and un- 
der the careful observation of municipal health au- 
thorities. Moreover, such an examination should be 
made whenever there is suspicion of contamination. 
There is no filter or domestic remedy which may be 
safely accepted as a substitute for this. This is in 
line with modern sanitation and not an impracticable 
procedure, for it is quite probable that every State 
in the Union as well as every city is equipped with 
laboratory facilities where water and other suspected 
fluids and solids are examined free of charge. Be- 
sides, the means of communication throughout the 
country are now so extended and rapid that even in a 



WATER 83 

remote section a report may be obtained within a com- 
paratively short time. In addition there are many pri- 
vate laboratories located throughout the country where 
such examinations are made for a small fee. A de- 
creased mortality would furnish proof as to the value 
of this means of public protection. 

There are, of course, many instances where a lab- 
oratory report cannot be obtained promptly and the 
exigencies of the occasion demand that some immedi- 
ate action be taken to protect the community against a 
presumably contaminated water supply. Fortunately 
there is a means which is unfailing in its action, always 
available and practically without cost; that is, the ap- 
plication of heat by boiling the water. By this means 
all disease-bearing germs which affect human beings 
are promptly destroyed. To accomplish this water 
should be continuously boiled for at least five minutes ; 
simply bringing the water to a boiling point does not 
always answer the purpose. 

Boiling renders the water somewhat flat to the taste 
as the air which it contains is expelled by the heat. 
This may be overcome by aeration, or by agitating the 
water in an ordinary churn which is known to be clean,. 
or letting it escape through a receptacle containing 
numerous little holes in order that it may be finely 
divided and better combine with the air in its descent 
to another receiver. It is far safer, while the emer- 
gency exists, to drink the water as it is boiled rather 
than employ means which through carelessness may 
again infect it, unless some person in the house is ap- 
pointed personally to take charge of the work. 



84 GOOD HEALTH 

One of the dangers of traveling by sea in the past 
was due to the contamination of drinking water on 
shipboard. This supply was carried in casks or tanks 
which were often in a filthy condition, and through 
carelessness infectious germs were not infrequently in- 
troduced into these receptacles and diseases transmitted 
to those on shipboard. Now all war vessels and the 
great ocean passenger steamships have distilling appa- 
ratus on board which render sea water fit and pure 
for drinking purposes in an inexhaustible amount. 
There is no doubt that in the future this method of 
obtaining water free from contamination will be greatly 
extended. 

In connection with the subject of water, it is proper 
that some reference be made to ice. It is a common 
belief that infectious organisms existing in water are 
destroyed when freezing takes place. This does not 
always occur, for some special organisms survive the 
reduction of temperature. This has been proved in 
the case of the germs of typhoid fever. 

Although natural ice may be obtained from sources 
where there is no serious contamination, it is well 
known that it frequently comes from bodies of water 
which receive sewage from large towns. To what 
extent ice under these circumstances becomes involved, 
it is, of course, impossible to determine, although the 
danger from this source is largely overestimated. 

In guarding against the danger from impure ice it 
would seem practical and logical to use the kind of ice 
which so far as we can ascertain is least harmful. Ar- 
tificial ice is more apt to be pure, for it is usually made 



WATER 85 

from distilled water. It is sometimes stated that it is 
rendered unsafe by the ammonia used in its manufac- 
ture, That is not so, for the ammonia does not come 
in direct contact with the water, but is confined in 
pipes, and used simply for freezing purposes. 

The more common danger from ice relates to the 
careless manner in which ice is stored and conveyed 
from the storehouse to the table. This may constitute 
a very fruitful source of contamination. Unfortu- 
nately, this receives but little attention from the public. 



CHAPTER V 



FOOD 



Food has been likened very properly to the fuel 
which supplies an engine with motive power. Food 
generates heat and energy and by this means keeps 
the body in a state of activity. But food in addition to 
this is required to replace worn out tissues and furnish 
nourishment for increased growth. 

Scientists have determined the composition of the 
human body and the character of the food best suited 
for its support^ and were it possible to give directly 
to the various tissues the material most needed for 
their sustenance, as well as substances best suited for 
the generation of heat and energy, the problem of nu- 
trition would be easily solved ; but the food we eat is 
subjected to the processes of digestion and assimila- 
tion and therefore reaches its destination in a changed 
and roundabout way. Still, the knowledge we possess 
of these processes enables us to do much toward se- 
curing the desired results. 

For instance, we have learned that bone is composed 
of animal and earthly matter which furnishes elasticity 
and strength. Bone, therefore, must be supplied with 
food suitable for maintenance of both of these ele- 
ments ; if not, trouble is quite sure to follow. If there 

86 



FOOD 87 

is not enough earthy matter present in the form of 
lime, the bones are Hable to become bent and distorted,, 
particularly in the lower extremities which support the 
weight of the body. This frequently takes place in 
rickets, a disease which not uncommonly affects chil- 
dren. On the other hand, the muscular system, which 
renders the body capable of the freest movement, re- 
quires a different kind of food to maintain its integrity. 
Then, again, the secretion-producing organs of the 
body which have most important functions to per- 
form, must be provided with plenty of water, various 
salts and other materials from which to manufacture 
their special product. 

NUTRITION 

At the risk of entering a more technical field, some 
space will be devoted to the consideration of the vari- 
ous groups of food, the terms which are used to dis- 
tinguish them from each other, and their relative value 
as tissue builders and generators of heat and energy. 

Food is classified as organic and inorganic. 

Organic substances consisting of animal and vege- 
table matter are subdivided into those which contain 
nitrogen and those which do not. 

The organic nitrogenized foods are known as pro- 
teins, a word which means ''the most necessary food." 
This class of food is truly necessary, for the nitrogen 
contained in it is required in the construction of new 
and the repair of old tissues and in the proper nour- 
ishment of the body. Without it we could live but 
a short time. Nitrogen used in this way is taken 



88 GOOD HEALTH 

into the system in the food and not in connection 
with the air we breathe. The function of nitrogen in 
the air, as we have already learned, is chiefly mechan- 
ical, for it dilutes the oxygen which otherwise would 
be too stimulating for respiration. 

Some of the more common and well known forms of 
proteins are meats, the albumen or white of egg, the 
casein of milk and the gluten of flour. The chief 
function of proteins is the building and repair of tis- 
sues, muscle for instance. They are also used to a 
certain extent in the generation of heat. 

The organic noii^nitrogenized food, as the name im- 
plies, contains no nitrogen. It occurs in the forms of su- 
gars (carbohydrates) and fats. Starches, which through 
various sources form an exceedingly important part of 
our diet, are also included with the former, for during 
digestion they are transformed into sugar, the form in 
''vhich they enter the system. The organic non-nitro- 
genized substances are not concerned in tissue building, 
but are heat and energy producers, and therefore im- 
portant agents of nutrition. 

Fat has also a mechanical function. It is deposited 
immediately under the skin as well as in the deeper 
structures. As it is a poor conductor of heat and cold, 
it aids in retaining the warmth of the body and pro- 
tects against the cold from without. Fat is also found 
over parts exposed to pressure, where it acts as a pad 
or protector against injury. Furthermore, it goes far 
towards maintaining the symmetry and beauty of the 
body. 

Both organic nitrogenized and non-nitrogenized sub- 



FOOD 89 

stances in supplying nourishment and energy lose their 
identity, i. e., they become changed in character, and 
are not recognized in the waste matter expelled from 
the body through the intestinal tract, kidneys, lungs 
and skin. 

Inorganic substances consist of water and various 
salts, for example, common salt (sodium chlorid), 
lime, soda and magnesia. These are necessary to 
maintain life. Everyone who has lived in the country 
is familiar with the importance of supplying cattle and 
other livestock with sufficient salt; if deprived of it, 
they generally decline in health and die. 

The inorganics are especially needed in connection 
with the various secretions which have been referred 
to in a previous chapter. Inorganic, unlike organic 
substances, are eliminated from the body in the same 
form in which they enter. Water and salt, for in- 
stance, enter the body, perform their functions and are 
discharged as water and salt. 

Many of the former theories concerning nutrition 
have been abandoned as the result of recent investiga- 
tion. For instance, it has been quite clearly demon- 
strated that proteins do not directly form or repair old 
tissue, but that all food entering the body undergoes 
a chemical change, known as digestion ; and that fol- 
lowing this the food products either are used for con- 
struction and repair of the various tissues of the body, 
or are burned to produce heat and energy. The latter 
is due to the presence of oxygen which is abstracted 
from the air in the lungs by the blood as it passes 
through these organs. The sum of the chemical 



90 GOOD HEALTH 

changes which take place under the influence of living 
cells is known as metabolism. 

DIET 

Having considered in a general way the material re- 
quired for the nourishment of the body, we are better 
able to understand the value of the various articles 
of food, particularly under special conditions. It has 
been the custom of athletes while in training to eat 
sparingly of sugars and fats which increase the weight 
and arp believed to add little to the muscular power 
of the body, but to depend chiefly upon proteins, such 
as eggs, meat and the like, from which to secure ad- 
ditional strength and proper material to replace worn 
out muscular tissue, for there is a pressing need of 
this during long continued and excessive muscular 
exercise. Proteins may be depended upon to do this ; 
however it is now thought that sugars and fats are 
also factors in maintaining strength — for a while at 
least. In confirmation of this it is reported that dur- 
ing the present war, German soldiers have been sub- 
jected to prolonged and active exercise with a very 
limited supply of protein food. 

During convalescence from fevers or where emacia- 
tion exists, as in tuberculosis and other wasting con- 
ditions, fats and sugars are particularly indicated to 
make up for the general drain on the system, although 
proteins are also required. Aside from these special 
or temporary conditions, it will not be difficult to 
understand that a mixed diet which contains all forms 
of food is essential to continued health and strength. 



FOOD 91 

During the past half century much has been done 
in the way of excluding fish, flesh and fowl from the 
diet, and also confining the character of the food 
within even narrower limits — to fruits and nuts, vari- 
ous grains, etc. Many societies have been formed for 
this purpose, the supporters being known as vegeta- 
rians, fruitarians, etc. Some of the advocates of these 
theories believe that in their practice they are dispens- 
ing with proteins. This is not a fact, for protein is not 
confined to meats and eggs, but is found in vegetables, 
often in large amount. Peas contain about twenty per 
cent of nitrogenized food ; some of the cereals are also 
rich in proteins. Yet vegetarians have done a vast 
amount of good by furnishing reliable evidence that we 
eat far too much meat and that this practice impairs 
digestion, tends to make those who are intemperate in 
this direction nervous and irritable, and later in Hfe is 
unquestionably an important factor in causing organic 
diseases and other serious ailments. Conditions do 
exist where a generous supply of meat is not out of 
place, as in the case of those whose work involves con- 
tinued severe physical exercise. Unfortunately, how- 
ever, a full diet of meat is commonly partaken of by 
those of sedentary habits. 

As we have already learned, the function of food is 
not limited to the nourishment of the body. It must 
also generate heat and energy, as fuel does for the en- 
gine. In order that health may be maintained it is nec- 
essary that the body shall be kept at a temperature of 
about 98.6° F. With the many influences which af- 
fect the human system, it is one of the wonders of 



92 GOOD HEALTH 

nature that this standard is maintained ; yet this is the 
case, for while food furnishes the fuel which gener- 
ates the heat, means are provided to regulate it. No 
more practical or interesting illustration of the latter 
can be given than the protection which nature extends 
in this way in the case of firemen or stokers who feed 
the furnaces in the great ocean steamships and who 
are often subjected to a temperature of 125° F. 
or even higher. If the temperature of the body were 
raised to this point, death would quickly follow. Under 
these extreme conditions, the normal temperature of 
the body is maintained chiefly by profuse perspiration 
which neutralizes the external heat by evaporation. 
Nature can continue this unusual condition only for a 
limited time, and men who are thus employed must be 
frequently relieved by others, otherwise death or seri- 
ous illness may occur as the result of what is known 
as *'heat-stroke." The temperature of the body is 
often raised by internal causes, such as infection, and 
medical and surgical treatment is required to assist 
nature to overcome it. 

The reduction of the body temperature below its 
normal register must also be carefully guarded against, 
for if this goes too far, equally serious results will fol- 
low. Aside from disease, this condition is usually the 
result of climatic conditions where the temperature is 
very low. If the exposure lasts for a short time only 
and the person is in good health and well clad, he is 
not seriously affected ; but when long exposure is con- 
templated, means must be taken to prevent injury from 
this cause. In the Arctic regions where the tempera- 



FOOD 93 

ture is continually very low, the person must not only 
be provided with very warm clothing, but must eat 
food which generates the greatest amount of heat. The 
diet of the Esquimaux is largely fat, usually in the 
form which would be nauseating to an inhabitant of 
the temperate or torrid zone and which would cause 
great discomfort and probably disease. 

We may feed an engine too much fuel, or use fuel of 
an improper kind. So may we take more food than 
we need for the nourishment of the body and the gen- 
eration of heat and energy, or we may partake of food 
which is deficient in nourishment, difficult to digest 
and disturbing to the machinery which disposes of it. 

These various conditions have led scientists to make 
a most careful and painstaking investigation concern- 
ing potential energy^ or value of the various forms of 
food. This is now reckoned by calories. In plain 
words, a calory represents the amount of heat neces- 
sary to raise the temperature of one pound of water 
about 4° F. The experiments in this direction are 
made by burning the various articles of food in an 
apparatus in which the heat generated may be meas- 
ured. 

While this work goes far to establish a standard by 
which a normal diet may be approximately determined 
and rendered available for practical use and to furnish 
suggestion as to the character and amount of food best 
fitted for our nourishment, it must be borne in mind 
that this means of estimating food value deals with the 
subject largely from a theoretical standpoint. The 
heat developed by a certain form of food in experi- 



94 GOOD HEALTH 

mental or laboratory work probably does not corre- 
spond to the amount of heat generated by it in the 
body, for here it is subjected to various changes over 
which we have little or no control. Besides, every per- 
son does not respond in the same way to the heat- 
and energy-producing capacity of food. 

Not only have scientists determined the relative 
amount of proteins, sugars and fats in the various 
foodstuffs, as well as the tissue building and caloric, 
or heat and energy, value of these articles, but esti- 
mates have been made as to the number of calories we 
need during the day to maintain the proper nourish- 
ment of the body. 

It is well known that persons of sedentary habits 
do not need as much food as those who perform man- 
ual work or are otherwise physically active. Under 
the former conditions, it is believed that food repre- 
senting about 2,500 calories is sufficient for the day's 
supply. An increase in this amount, however, is called 
for to sustain a person engaged in continued active 
exercise or at hard labor. This may require a daily 
supply of 4,000 to 5,000 calories. Naturally there is 
some difference in the estimates given by various in- 
vestigators, for the scientific deductions regarding this 
detail of the subject are largely theoretical. 

Valuable tables have been prepared enabling us to 
make practical use of the knowledge above referred to, 
and they furnish a valuable guide in the selection of a 
healthful and serviceable diet. 

It may be said concerning the relative amount of 
proteins, sugars and fats required for the proper main- 



FOOD 95 

tenance of the body, that about ten to twenty per cent 
should be proteins, something less of fat, and the re- 
mainder, or greatest portion, should be carbohydrates. 
The latter material constitutes the most important 
agent in the generation of heat and energy, aided by 
fats, although they have practically nothing to do with 
the repair or building of tissues ; whereas the proteins 
are alone concerned in this work, and contribute com- 
paratively little toward the production of heat and 
energy except in emergencies. 

The accompanying table is presented as a means of 
elucidating what has just been said regarding this part 
of the subject of nutrition, and is of practical impor- 
tance in showing that proteins are not confined to meats, 
eggs, etc., but are found to a large extent in vegetables 
and cereals and that proteins in the latter form may 
often be used as a substitute for meat. The great eco- 
nomic value of this is apparent. 

It is important in a general way that the public 
should be familiar with the scientific researches above 
referred to; but it would be unwise and impractical 
for a person to depend upon these data for the ar- 
rangement of a diet for daily use. It would be not 
only largely a matter of theory, but it would lead 
to all sorts of experiments and produce many so- 
called food cranks. It must be borne in mind that in- 
stinctively each race of people knows the food best 
adapted for its use. Besides, the appetite of a healthy 
person is a most excellent criterion of what form of 
food is best for him. The digestive apparatus, in its 
acceptance of the various articles of diet thrust upon 



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98 GOOD HEALTH 

it, is not by any means alike in everyone. Many per- 
sons include milk and eggs in their daily menu without 
the slightest digestive disturbances, while others can- 
not take these articles of food without great discom- 
fort. Therefore, while they are among the most 
valuable forms of nourishment, it is often unwise to 
depend upon them for sustenance. 

Far too little attention has been given to this phase 
of the subject. If a person is in normal health, the 
continued repugnance of the alimentary tract to certain 
articles of food, provided they are properly cooked, 
should be accepted as an indication that other forms of 
nourishment, having about the same tissue building and 
fuel value, should be substituted. 

It is commonly believed that when a large amount of 
food is taken the portion not actually required at that 
time is stored up for future use, and is of value when 
waste occurs in disease or other disabling conditions. 
While in a measure this is true as far as sugars and 
fats are concerned, there is sufficient proof that it 
does not apply to proteins. Furthermore, when pro- 
teins are taken in excess, they cause extensive fermen- 
tative and putrefactive changes in the intestinal tract, 
and not only lead to the absorption of poisonous prod- 
ucts into the system, which is responsible for many un- 
pleasant and often serious conditions, but overtax vari- 
ous organs of the body. 

There is no habit more destructive to health and 
more certain to cause serious results than overeating. 
Particularly are these evils manifest late in life in the 
form of various diseases. Besides, investigation now 



FOOD 99» 

under way is likely to prove that intemperance 
in eating is more or less responsible for diseased! 
blood-vessels, which lead to apoplexy. It is not diffi* 
cult to understand that these conditions are far more 
common among the well-to-do, who can indulge in 
overeating, than among the poorer classes, who eat 
plain, simple but nourishing food, and less of it. The 
overeating of meat is most frequently indulged in, for 
almost everyone who can afford it is apt to consume- 
too much of it. 

It will require but little study on the part of each 
person to ascertain not how much he can eat, but 
what is the minimum amount of food required to- 
maintain good health. The reward for this will be 
extremely gratifying, for it will go far to prove what, 
has been said regarding the value of a simple diet. 

Before leaving this part of the subject a word may 
be said concerning the use of condensed foods or food 
extracts as a substitute for the ordinary articles of 
diet. Some of the arguments in favor of this means 
of nourishment relate to the very greatly reduced bulk 
in which they may be obtained, the small capacity re- 
quired for transportation and the fact that food in 
this form is not so apt to be affected by climatic condi- 
tions. There is no doubt that in emergencies or in 
certain diseases or for a very short period foods pre- 
pared in the manner above referred to may be of great 
value in sustaining life, but they are unfit for continued 
use. Those who believe otherwise are unmindful of 
the fact that the large amount of material we eat in 
order to obtain a small percentage of proteins, sugars 



100 GOOD HEALTH 

and fats — in vegetables for instance— has an exceed- 
ingly important function of its own in stimulating the 
alimentary tract, furnishing certain saits and in other 
ways is of great importance in the preservation of 
health. 

It is sufficient to know that food extracts and con- 
densed foods should not be depended upon in place of 
a natural diet. Furthermore, whole grain contains 
more nourishment than when the envelope or husk is 
removed. A striking illustration of this will be re- 
ferred to in the consideration of rice as an article of 
food. 

Some of the more important foodstuffs call for spe- 
cial notice. 

Milk may be regarded as the most valuable form of 
nutrition, for it contains practically all the substances 
necessary for our existence : proteins, sugars and fats, 
etc. No other form of food is required in early life, 
and an adult may subsist on it for a while, but as it 
consists of about 87 per cent of water, it cannot be 
depended upon indefinitely to maintain the health of a 
grown person. 

The various products of milk are so well known 
that they require only brief notice. Cream is that 
portion of milk which is rich in fat, and being lighter 
than milk rises to the surface. When the cream is re- 
moved, skimmed milk is left. Butter, which amounts 
to about four per cent of milk, is abstracted from the 
cream by churning, the remaining fluid being known 
as ''buttermilk.'' Cheese is made from milk by coagu- 
lating the casein or protein substance with rennet or 



FOOD loi 

lactic acid. In making soft cheese, like Brie and Cam- 
embert, the curd is simply placed in molds, while hard 
cheese, the more common form, is subjected to pres- 
sure. Of the enormous output of milk in the United 
States, three-quarters of it is used for butter and 
cheese. 

Although from a general standpoint milk is the most 
important article of diet, it is also responsible for more 
sickness than any other form of food, for it is com- 
monly taken raw, and in this state it is almost impossi- 
ble to avoid some form of contamination. This is due 
chiefly to the presence of bacteria. While certain 
forms of these germs in milk may excite only local 
trouble, as stomach and intestinal afifections of chil- 
dren, others known as pathogenic organisms may 
transmit infectious diseases, such as typhoid fever and 
diphtheria. 

It is not difficult to understand why contamination: 
occurs when we consider the various means by which 
this may take place: filthy condition of the cows and 
hands of the milker, insanitary stables and unclean 
receptacles in which the milk is contained from the 
time it is drawn until it is consumed. To prevent this 
contamination is the problem which health officials are 
constantly trying to solve. , 

The milk supply of a great city necessarily comes 
from many sources which it is impossible to control 
satisfactorily. For instance, New York City consumes 
daily over 2,000,000 quarts of milk brought from all 
parts of the country within a radius of two or three 
hundred miles, much of it from dairies which are not 



:i02 GOOD HEALTH 

in proper sanitary condition. Therefore, the purity 
of the cow's milk in its natural state cannot be de- 
pended upon, unless a dairy and its methods can b^ 
kept under personal observation, possible only where 
the dairy is close by. There are important advantages 
gained in this way, for milk in its natural state is far 
more valuable as an article of diet than that which has 
been ''treated." 

In order that milk may be made safe without being 
treated, commissions have been formed in some of the 
large cities to inspect and keep under careful observa- 
tion certain dairies. The owners of these dairies enter 
into an agreement to carry out such regulations as may 
be prescribed by the commissions to insure proper 
sanitary conditions about the dairies and to enforce 
clean and wholesome methods of handling the milk 
from the time it is drawn until it reaches its destina- 
tion. In return the commissions recommend this milk 
for general use. 

This is known as ''certified'^ or ''inspected'' milk and 
is naturally more expensive, and hence is used only 
b)y a small proportion of the public. For this reason 
the municipal authorities in many places recommend 
or require the pasteurization of milk; while in others, 
little action or interest is taken in this important 
matter, and each family must investigate its own milk 
supply. 

While boiling is certain to destroy all germs con- 
tained in the milk and is the safest, simplest and most 
effective means which can be employed in emergen- 
cies, the heat required, 212° F., renders the milk less 



FOOD 103 

valuable for purposes of nutrition. Therefore a more 
permanent means of purification — pasteurization — has 
been generally accepted. 

Pasteurization is a very simple process. It usually 
consists in subjecting the milk to a temperature of 
150° F., for twenty minutes and then replacing it 
upon the ice. This temperature, which is below the 
boiling point and cannot be depended upon to kill all 
forms of bacteria, will destroy the germs of tubercu- 
losis and render harmless other infectious organisms 
which may be present. 

Pasteurization is now carried out on a very large 
scale by dairymen in response to certain municipal 
regulations. It may also be easily done at home in the 
following manner: The milk is put in bottles which 
are tightly closed, sealed and placed in a pan and 
covered with water. The water is raised to a tempera- 
ture of 150° F. and kept at this point for twenty 
minutes. The bottles are then removed and placed in 
the icebox close to the ice, and, after being cooled, the 
milk is ready for use. 

The public should carefully avoid the use of powders 
and other mixtures advertised as preservatives of milk. 
These are not equal to the methods just referred to,, 
and may do considerable harm. 

The public should also be warned against the use of 
what is termed ''dipped milk" ; that is, milk which is 
dispensed from cans in various places. This is always 
contaminated, as the receptacle is opened not only 
when a sale is made but often left open at other times. 

Many, both young and old, are unable to take cow's 



304 GOOD HEALTH 

milk, as it curdles or ferments too quickly on coming 
in contact with the acid secretions of the stomach, and 
is often the cause of indigestion. In human milk the 
curd forms more slowly, therefore it is far better 
adapted to the nourishment of the infant. When it is 
necessary to use cow's milk at this period of life, lime 
water and other agents are added to prevent the rapid 
*curdling. Cow's milk is easily digested by the calf, as 
its stomach is prepared to break up the curd. 

In the Far East the objection to animal milk, on ac- 
count of the curdling and the digestive disturbances 
which occur, is largely overcome by fermenting it be- 
fore it is taken into the stomach. By this means the 
•curd which forms is broken up and dissolved. Kumyss 
is an illustration of this and is now well known in this 
country. 

Other forms of fermented milk are also extensively 
used throughout the world under different names 
with the most satisfactory results. Besides, the acids 
which are formed during fermentation are believed to 
prevent to a great extent the putrefactive changes 
which occur in the intestinal canal from which so many 
persons suffer. Milk thus treated is not to be regarded 
as medicated and may be taken in about the same 
quantity as ordinary milk if it is pleasantly received. 
If not promptly used, the acid fermentation continues, 
and these products become too sour and objectionable 
for use. While the addition of vichy and seltzer water 
may to a certain extent overcome this, it is far better 
that they should be freshly prepared, particularly when 
used for invalids. 



FOOD 105 

In many sections of the East but little else besides 
fermented milk is taken for food, and it has been said 
that a hundred years is not an extraordinary age 
among the natives. This is very important evidence 
that nothing more surely guarantees the prolongation 
of life than a proper amount of sirnple and nutritious 
food, particularly that which will cause the minimum 
amount of putrefactive changes. 

As kumyss and other forms of fermented milk sold 
in stores are comparatively expensive, their use is nec- 
essarily restricted. This form of nourishment, how- 
ever, should be familiar to every household, for it is 
very valuable and refreshing as an article of diet. 
Kumyss may easily be made at home and at a cost 
which hardly exceeds that of milk. The following 
is one of the various formulae : 

Before preparing the kumyss, bottles for its reception 
should be made ready; beer, citrate of magnesia or 
other bottles*having the patent tight-fitting cork answer 
all purposes. These should be carefully cleaned and 
left in boiling water for five minutes, then taken out 
and drained. 

For the first experiment put two quarts of milk in a 
porcelain or granite-ware receptacle, and place over a 
slow fire. Add one level tablespoonful of salt and two 
small tablespoonfuls of granulated sugar; the amount 
of sugar may be increased or decreased as it is desired. 

Dissolve one-half of a compressed yeast cake 
(Fleischmann) in half a teacup of water. 

Stir the milk slowly while warming, and do not over- 
heat it; when lukewarm add the dissolved yeast cake, 



io6 GOOD HEALTH 

take the receptacle off the fire and stir the contents 
slowly to mix the yeast thoroughly. Then fill the bot- 
tles only just above the shoulder, leaving a space 
which will prevent the gases formed by fermentation 
breaking the glass. 

When filled, lay the bottles in a warm place and 
cover with a blanket for about ten hours, turning each 
bottle half way every hour or two; at the expiration 
of this period lay the bottles in the icebox until thor- 
oughly cooled, when they are ready for use. Turn 
over the bottles of kumyss in the icebox once each day. 

Considerable patience is required until the details 
connected with the manufacture of this article are fully 
mastered. It must be specially borne in mind that 
kumyss, like champagne, contains a gas which is par- 
ticularly lively, and therefore the bottles must be care- 
fully opened. A clean towel placed over the mouth of 
the bottle when being opened will protect one's cloth- 
ing from the kumyss which escapes with considerable 
force. 

In localities where the conditions of the dairies from 
which the milk supply is obtained are known to be 
sanitary, the question of pasteurization need not be 
raised, for it may be repeated that this process does 
to a certain extent affect the food value of milk. 

Wherever the municipal health authorities enforce 
strict regulations concerning the public milk supply it 
is only necessary that each family should deal with 
a milkman who is known to be reputable, who is care- 
ful in his selection of the milk he sells, and who com- 
plies faithfully with municipal regulations. 



FOOD 107 

Milk is best preserved by a low temperature between 
32° (freezing) and 50° F. While this does not de- 
stroy the bacteria contained in the milk, it renders 
them practically harmless for the time being, and the 
milk does not become sour, although later it may be- 
come unfit for use in other ways. Therefore it is very 
necessary that every home should contain a properly 
constructed icebox, for the preservation not only of 
milk, but of other food products which also decompose 
rapidly in warm weather. 

The meat we eat is obtained from animals, princi- 
pally cattle and sheep, which are herbivorous, and as 
a rule are not subjected to physical work. Horses are 
given proteins, usually in the form of oats, corn and 
hay, to increase their muscular power and efficiency, 
and for this and other reasons their meat is coarser 
and not as palatable as that of the above mentioned 
animals. 

It will be observed in the accompanying table that 
a pound of fresh meat is equal to 1,200 or 1,500 calo- 
ries, and contains from 17 to 20 per cent of proteins, 
about the same amount of fat and no carbohydrates ; 
lamb has about the same constituents. Therefore the 
value of meat as protein food is apparent. 

Meat is sometimes contaminated or diseased, and 
under these conditions its use may be followed by un- 
pleasant or dangerous results. This applies chiefly to 
hog meat, and occasionally to veal. It may be due to 
chemical changes known as ^'ptomaine poisoning," or 
the presence of certain forms of bacteria and parasites. 
Poisoning from this source occurs in sections of the 



io8 GOOD HEALTH 

world where food is eaten uncooked or only slightly 
cooked. These results may be prevented by subjecting 
the meat to a sufficiently high degree of heat to kill 
the bacteria and parasites which are present. Protec- 
tion against the danger from this source is usually se- 
cured by the various methods of cooking employed in 
this country, although when the center of the meat re- 
tains its redness after cooking it is questionable if the 
proper degree of heat has been reached. 

Beef and lamb or mutton are so seldom contam- 
inated in the manner above described that it should not 
deter those who prefer these meats rare from contin- 
uing their use, provided care is observed in purchas- 
ing them. 

It would be out of place and unnecessary to recite 
in this book the various means by which meat may be 
contaminated. As a protection against this condition, 
each family should give proper time and attention to 
the selection of a dealer who purchases his meat care- 
fully and provides proper sanitary receptacles for it 
while it is in his possession. 

Poultry is more easily digested and less stimulating 
than meat, and is therefore more suitable for con- 
valescents and those with weak digestive apparatus. 
Chickens and turkeys have about the same percentage 
of proteins and fats as beef and lamb; however, their 
caloric or fuel value is somewhat less. Game, such as 
quail and partridge, is tender and easily digested. The 
practice of keeping game, however, for a prolonged 
period for the purpose of developing certain flavors 
cannot be regarded as wholesome. 



FOOD 109 

Fish is more digestible, but has less protein and far 
less fat than meat, and is therefore less stimulating and 
supporting than meat. A pound equals about 400 
calories. Fish must be eaten fresh, for it decomposes 
rapidly and in this condition is absolutely unfit for 
use. 

Oysters are . nutritious, although they contain even 
less protein than fish, and but a very small percentage 
of fat; therefore their caloric value is very low. They 
are easily digested, but they must also be eaten fresh. 
Oysters may be polluted by sewage if they are 
grown in waters which are greatly contaminated. How- 
ever, it is quite probable that the dangers from this 
source are greatly exaggerated and may be avoided if 
reasonable care is taken to ascertain whence the oysters 
came. In many instances their beds are far removed 
from probable contamination. 

Lobsters and crabs contain considerable protein, are 
very palatable and, like oysters, have very little fat. 
They are fit to eat only when fresh ; serious results 
may follow a disregard of this rule. This is also par- 
ticularly true of mussels, and it is much safer to ex- 
clude them as articles of diet. 

It is hardly necessary to refer to the importance of 
eggs as an article of food, for their value is well 
known. The white of an egg, or albumen, is the pro- 
tein substance, and the yolk is composed largely of 
fat; this makes an tgg an exceedingly valuable mixed 
diet. One good-sized tgg is equal to about 100 calo- 
ries, and contains 13 per cent of protein and 10 per 
cent of fat. 



no GOOD HEALTH 

While eggs cannot be adulterated, we are often de- 
ceived as to their freshness, for they may be kept in- 
definitely by preventing air from passing through the 
shell. This is accomplished by packing, by immersion, 
or by coating them with an impervious material, such 
as wax. Various tests are employed to detect stale 
or bad eggs, but these cannot be depended upon except 
by an expert. It is far more important to have a re- 
liable source of supply. 

Butter is the milk fat and has already been referred 
to. Butter is more palatable than, and far superior to, 
all other forms of fat for nourishment of the body, and 
far too little of it is used even when the question of 
expense is not a factor to be considered. Butter is 
very easily digested, and is a particularly important 
article of diet to those who are weak and badly 
nourished and suffering from wasting diseases. 
Butter contains over 80 per cent of fat and only 
one per cent of protein; therefore, its fuel value is 
very great. A pound of butter equals nearly 3,500 
calories. 

Cheese is very rich both in fats and proteins. Among 
the poorer classes in Europe it often forms a large part 
of the diet. While it is very nourishing and particu- 
larly palatable, it is often hard to digest, and there 
are few who can eat a large amount of it without some 
disturbance of digestion. 

The importance of cereals as food may in a measure 
be indicated by their general use throughout the world. 
Wheat, corn and oats are the most valuable articles of 
this class. It is from the cereals or grain that we are 



FOOD III 

chiefly supplied with starches which furnish not only 
nourishment, but a large part of the heat and energy 
generated in the body. 

The various ways in which wheat may be used for 
food are too well known to call for extended comment. 
Bread, which is made largely of wheat flour, is very 
properly regarded as the '*staff of life,'' for wheat con- 
tains both nitrogenized and non-nitrogenized sub- 
stances, is easily grown and less expensive than many 
other articles of diet. 

The great value of oatmeal as an article of food is 
far from being fully appreciated. It has been stated 
that a pound of oatmeal is as valuable as two pounds 
of meat. There is considerable truth in this saying, 
and it is only necessary to examine the table contained 
in this chapter to recognize the richness of oatmeal 
in proteins and other substances required for a mixed 
diet. We may turn to the horse for evidence as to its 
value in furnishing power and endurance. Oatmeal 
contains about 13 per cent of proteins, 6 per cent of 
fat and at least 65 per cent of carbohydrates — almost 
an ideal food. The fuel value of a pound of oatmeal 
is given as 1,700 calories. The economical value of 
oatmeal is readily apparent. 

Formerly oatmeal was improperly milled. This has 
been overcome by new and greatly improved processes, 
but the fact remains that oatmeal is not as a rule prop- 
erly or sufficiently cooked for the table. Because of 
this it is often served in a slimy, sticky and unpala- 
table condition. Every housewife shoukl study how 
to make this extremely important food a favorite 



112 GOOD HEALTH 

article of diet, for its value is as great in the homes of 
the rich as among the poor. 

Although probably one-third of the population of 
the earth subsists on rice, it is poor both in proteins 
and fats, and does not provide the important elements 
of nutrition which are found in other cereals. 

Some very interesting results have been obtained 
in connection with the investigation of beriberi, a dis- 
ease evidently due to malnutrition. It is largely preva- 
lent in Japan, the Philippines, and other sections of 
the world where rice is the principal article of diet, 
particularly among the poorer classes. 

These researches have shown that beriberi is un- 
doubtedly caused by a diet of polished rice, that is, 
rice from which the outside covering or shell has been 
removed. It has been shown that this covering is the 
most nourishing part of the grain. The proof of this 
lies in the fact that since the whole rice has been used 
in the places above referred to, beriberi is rapidly 
disappearing. 

This clearly shows that we should not depend upon 
any one article of diet, for it allows too little margin 
upon which to maintain health, even if it is rich both in 
nitrogenized and non-nitrogenized substances, and that 
a mixed diet is necessary for the proper nourishment 
of the body. 

Peas and beans are rich in fats and proteins. A 
good dish of soup made from either of these articles 
makes an excellent meal. 

Although deficient in fats and proteins, potatoes 
form a very valuable article of diet, for they contain 



FOOD 113 

a large amount of starchy food. Besides, the acid 
juice of the potato is of special value, for, in common 
with other vegetable and fruit acids, it supplies a ma- 
terial which the system must have, and without which 
certain conditions of malnutrition are very apt to oc- 
cur. Scurvy, an excellent illustration of this, was com- 
mon among the crews of sailing vessels years ago 
when voyages were long and potatoes and other acid- 
ulated foods were not available. This does not now 
occur, for the law requires that outgoing vessels 
shall be supplied with a sufficient quantity of lime juice 
or other acids or acidulated foods to prevent such a 
condition. Besides, slow sailing vessels are now being 

J supplanted by steamships which make comparatively 
quick trips, and whose crews are not deprived of 
proper food. 

It is commonly believed that fruit is valuable as 
food. This is not true, for while it is exceedingly pal- 
atable, refreshing and more or less stimulating to the 
digestive apparatus, largely from the residue which it 
contains, it is with few exceptions, such as the banana, 
deficient in nourishment, for it is composed chiefly of 
water. Its value depends chiefly upon its delicious and 
refreshing acid juices, particularly when the fruit is 
fresh and clean. 

Persons are dififerently aflfected by fruit, and the ex- 
tent to which it may be eaten should be decided by the 
individual. Some can eat apples without any distress ; 
others are unpleasantly affected by this fruit. Under 
the latter conditions they should be avoided. Oranges 
contain a large amount of indigestible material. This 



114 GOOD HEALTH ^ 

is recognized where oranges grow, and the natives very 
skillfully extract the juice and the soft pulp and throw 
the remainder away. 

Lemon juice is often used in large quantities for an 
extended period, sometimes to reduce the weight of 
the body. While some may follow this practice with 
apparently no ill effects, or even with benefit, the con- 
tinued use of lemon juice, particularly in large 
amounts, is injurious, especially in connection with 
the teeth and digestive organs. 

From this we may learn that while fruit is very re- 
freshing and by supplying acid juices and stimulating 
the intestinal tract forms a very important part of our 
diet, it must not be used as a substitute for more nour- 
ishing substances. 

It is hardly necessary to speak of the frequency with 
which older persons as well as children are made ill 
by eating fruit, particularly that which is stale and un- 
ripe. This occurs more often among the poorer classes 
and in cities, where the supply is obtained largely from 
street vendors. Under these conditions the fruit is 
often not only unripe or decayed, but is also quite 
liable to be infected by dust and filth from the street. 
It may also be contaminated by the dirty hands or 
cleaning cloths of the vendors who frequently take 
home the supply left over at the end of the day's sale 
for the next day's business. No greater or more practi- 
cal charity could be inaugurated than the establishment 
throughout the tenement house districts of depots 
where fresh, clean fruit, as well as properly made ice 
cream and the so-called soft drinks could be supplied 



FOOD 115 

at a low cost. This would go far to overcome the dan- 
gers which often follow the consumption of stale and 
impure products. 

PREPARATION OF FOOD 

The value of food depends largely upon the manner 
in which it is prepared for digestion by cooking and 
mastication. The former process properly carried out 
renders meat and vegetables not only more palatable, 
but far more digestible by breaking up the fiber. In 
the raw state these articles are rough and stringy, and 
practically unfit to eat. Cooking also destroys infec- 
tious germs which may be concealed in the food. 

A word may be said as to the various methods and 
results of cooking. In dealing with meat it is some- 
times desirable that it should not only be cooked suffi- 
ciently to make it tender, but that its nourishing and 
savory juices should not be allowed to escape. Roast- 
ing, broiling and grilling secure this result, for the in- 
tense heat which is at first applied quickly coagulates 
and hardens the surface, and to a large extent prevents 
the juices from running ofif. On the other hand, boil- 
ing or stewing is for the purpose of extracting the 
nourishing juices from meat or other articles of food. 
This is done by placing the food in a receptacle con- 
taining cold water and raising the temperature to the 
boiling point, and maintaining this for some time. In 
this process both meats and vegetables are usually cut 
into small pieces, in order that the nourishment and 
flavors may be more easily extracted. 

There is one method of cooking which is less de- 



Ii6 GOOD HEALTH 

sirable than others ; i. e., frying. In this way the heat is 
applied through the medium of fat or oil which pen- 
etrates the food and renders it less digestible than 
other methods of cooking. 

One of the commonest errors in the preparation of 
food is the imperfect cooking of breadstuffs and cake, 
which renders them soggy and heavy. Under these 
conditions it is very difficult for the digestive fluids to 
penetrate the mass, and the food value is not only 
diminished, but digestion is seriously interfered with. 

DISTRIBUTION OF MEALS 

There are many theories regarding the proper time 
for eating and the number of meals which should be 
taken each day. The various opinions and recommen- 
dations which are offered on this subject denote rather 
individual preference, and cannot always be accepted 
for general guidance. 

It is a modern and very common practice to take for 
breakfast a small portion of fruit, a roll and a cup of 
coffee, and nothing more until noon or later in the day. 
This is based upon the theory that upon rising in the 
morning the digestive apparatus is not prepared to 
deal with a full meal and to assimilate it properly. 
This theory is without the least reasonable or logical 
foundation. If a person is in a normal condition, the 
digestive organs should be at their highest point of effi- 
ciency in the morning, as the work of the preceding 
day has been followed by ten or twelve hours of rest. 
Indeed there is no condition which more clearly indi- 
cates normal health than a good appetite upon rising. 



FOOD 117 

Breakfast should be the best meal of the day. 111 
health, dissipation or overeating will of course inter- 
fere with this. 

Like an engine, the body must have fuel to run it. 
In the morning the day's work begins, and good nutri- 
tious food must be supplied in order that the various 
functions of the body may be properly performed. A 
cup of coffee and a roll do not meet this requirement, 
particularly during the cold weather when the body 
needs material not only for food, but also for the gen- 
eration of heat. The fact that many follow this course 
and apparently do not suffer from it is no indication 
that it is a healthful and reasonable method to adopt, 
for it is not. It is detrimental to health and unfits a 
person for proper work during the day. 

At noontime the business of the day has reached its 
most active stage. The meal at this point should be 
small and should consist of articles which are easily 
digested. If a heavy meal is taken, an increased 
amount of blood is required for the digestive tract to 
perform its function, and as this is withdrawn largely 
from the brain, it materially interferes with the work 
of this organ. Under these conditions a person is apt 
to become sleepy and inactive. 

There are many who take no luncheon and feel much 
better for it, and this is not unreasonable if a hearty 
breakfast has been eaten, but not otherwise. On the 
whole it is probably better to take a small amount of 
very light and easily digestible nourishment at the noon 
hour. Later in the day the system naturally becomes 
reduced in power, and digestion is not so easily per- 



ii8 GOOD HEALTH 

formed unless there is plenty of exercise; therefore 
a bountiful meal in the evening, consisting of meat and 
other substantial foodstuffs is fortunately not required 
except by those who perform prolonged manual 
labor. 

Custom and experience have ordained that we shall 
eat three meals during the day. It is quite unlikely 
that this arrangement could be improved upon. How- 
ever, it is the character of the food we eat and the 
danger of intemperance in eating that demands the 
more careful consideration. Overeating applies rather 
to adults ; for with children a very liberal and nourish- 
ing diet is needed to provide not only for present pur- 
poses, but also for increased growth. It is advisable 
that young children be fed oftener than adults. 

There are those who omit breakfast for the purpose 
of reducing weight. This not only does not in itself 
produce the desired effect, but is an unhealthful expe- 
dient. It is exercise with a diminished amount of food 
properly distributed over the day, rather than a reduc- 
tion in the meals, which may be depended upon to 
lower a person's weight. Besides, it must be remem- 
bered that while persons are depriving themselves of 
food for this purpose, they may do it to such an ex- 
tent that the organs will not receive sufficient nourish- 
ment to perform properly their functions, and sooner 
or later unpleasant or serious results may follow. 

REDUCTION OF WEIGHT 

The great desire on the part of some people to re- 
duce their weight has been taken advantage of by char- 



FOOD 119 

latans, who offer for sale all sorts of nostrums for this 
purpose. Unpleasant and injurious results very often 
follow the use of these agents, for the body cannot 
with impunity be tampered with in the drastic and per- 
nicious manner involved in such treatment. 

Fortunately a person, if so disposed, may reduce his 
weight without resort to uncomfortable and dangerous 
practices. During recent years the increased knowl- 
edge which has come to us concerning the chemistry 
of food products and their relative nutritive value has 
offered simple and healthful means by which this result 
may be obtained, largely by a proper regulation of the 
diet. 

Fully ninety per cent of those who are fat or corpu- 
lent, particularly those in advanced years, have dis- 
obeyed the law of nature by the abuse of the digestive 
system. This has been brought about through overin- 
dulgence in food and drink, especially fats and car- 
bohydrates, and the want of proper exercise. There- 
fore, this condition cannot be attributed wholly to in- 
creasing age, for the symmetry and grace of the body 
may be indefinitely preserved if it has been properly 
cared for. 

In the reduction of the body weight by healthful 
means, two things are imperative : a proper diet con- 
taining a minimum amount of fats and carbohydrates 
and a sufficient amount of exercise, preferably walking. 
The value of both these hygienic measures will be 
fully discussed in a later chapter and the table has 
been introduced in this chapter (pages 96-07) to per- 
mit the selection of articles of food either rich or deti- 



120 GOOD HEALTH 

cient in proteins or carbohydrates according to the 
needs of the occasion. 

While a rigid diet for reduction of weight, which 
eliminates all foods known to contain a large amount 
of fats and sugar, is justifiable for a period sufficient 
to overcome obesity, it should not be carried too far or 
too long, for we thrive best upon a mixed diet, and 
if this is properly adjusted and sufficient exercise 
is taken — a most important consideration — there is 
no reason, unless some constitutional trouble ex- 
ists, why overweight should occur. It must be re- 
membered that too little of fats and carbohydrates 
may deprive the system of sufficient nourishment 
to maintain properly the functions and heat of the 
body. 

A word may also be said in regard to alcoholic 
drinks in connection with obesity, for while in them- 
selves they may to a certain extent increase the weight 
of the body they do this more directly by causing an 
abnormal appetite. 

A little more definite information may be imparted 
as far as the reduction of body weight is concerned by 
stating that such articles as bread and butter, milk, po- 
tatoes, cereals rich in carbohydrates, are the foods first 
proscribed, and are to be eliminated or used only 
sparingly. 

On the other hand, one may eat all kinds of lean 
meat, excepting hog meat, which is largely composed 
of fat. In addition fish and oysters may be added to 
this list as well as green vegetables, the latter not only 
for their nutritive value but also for the large amount 



FOOD 121 

of residue they contain which stimulates the intestinal 
tract and prevents constipation. 

Fruits, with the exception of bananas and others 
which contain a large amount of starch, may be eaten, 
but rather for their refreshing effect due to the acid 
juices. As a rule they cannot be depended on for 
nourishment. With these suggestions each one may, 
by consulting the accompanying table, prepare a diet 
which if persevered in and combined with walking is 
quite sure to reduce the body weight. 



CHAPTER VI 



DISPOSAL OF WASTE 



SEWAGE 

No part of the subject of sanitation has been studied 
more exhaustively than that which relates to the dis- 
posal of waste matter, particularly human excrement, 
for through the medium of infectious germs found in 
the latter refuse, dangerous diseases are transmitted 
from one person to another. 

The natural means of dealing with waste matter 
and sewage is to return it to the soil whence it came 
in such a way that it may be used as a fertilizer and 
enrich the ground without transmitting infection to liv- 
ing beings. This method is practised in various sec- 
tions of the world, and there is little doubt that in the 
future it will command more serious and widespread 
consideration. 

The waste or refuse matter to be disposed of in- 
cludes fecal matter, or discharges from the bowels, 
urine, slops, washings, filth of animals, refuse from 
stables and outhouses and also street dirt. In addition 
there are innumerable other forms of waste in con- 
nection with various trades and factories. It is neces- 
sary that this material shall be promptly disposed of 

122 



DISPOSAL OF WASTE 123 

in order to prevent offensive odors and possible trans- 
mission of infectious germs. 

The subject of waste disposal interests both city and 
country. In cities and towns the water carriage sys- 
tem is employed for the removal of house and street 
waste and filth. This system involves the use of large 
underground main pipes, or street sewers, which con- 
duct the waste matter to a river or some body of 
water for disposal. The individual buildings or prem- 
ises are connected with the street sewers by house 
drains, which in their turn receive the waste from 
sinks, basins, bathtubs and waterclosets located in the 
different apartments of the building. 

Although this method is in general use throughout 
the world, it often becomes an agent of infection by 
.polluting bodies of water into which the sewage is 
discharged, and which are sometimes used for drink- 
ing purposes. To prevent this, various means are em- 
ployed whereby the sewage, before it reaches its 
ultimate destination in some body of water, is treated 
either chemically or by filtration. The object of this 
is to destroy the infectious bacteria or germs and thus 
prevent the contamination of water which may be used 
for drinking purposes. However, these methods of 
purification cannot be depended upon for protection. 

The means of waste disposal employed in the coun- 
try, where there is no water carriage system, consists 
of privy vaults, cesspools and sometimes septic tanks. 
However, a large par^of the waste matter is deposited 
on the ground to be disposed of in natural ways. 

The usual drainage of a modern dwelHng house or 



124 GOOD HEALTH 

other building in a built-up community, consists of 
one or more lines of waste and soil pipes, depending 
upon the capacity and needs of the structure. These 
pipes are made of iron, the waste pipes being two 
inches and the soil pipes four inches in diameter. The 
joints of these pipes are sealed, or caulked, with lead 
to prevent the escape of offensive fluids or gases. 

The waste pipes connect with the basins, tubs, sinks 
and small receptacles throughout the house, while the 
soil pipes connect with the waterclosets. Under each 
fixture there is, or should be, a curved pipe somewhat 
similar in appearance to the letter S, known as a 
*'trap," the function of which is to hold water to a cer- 
tain level in the bend in order to prevent the entrance 
of sewer gases or offensive odors into the apartment 
through the fixture. If a number of these are con- 
nected with the same upright line of waste or soil pipe, 
the discharge and force of descending water or waste 
from a sink or watercloset might suck out, or siphon 
off, the water in the traps of another fixture on the 
same line; therefore, main soil and waste pipes are ex- 
tended four or five feet above the roof of the building 
with the top open and protected against the entrance of 
foreign matter by a cap or cover which does not fit so 
close as to prevent the entrance of fresh air. By this 
means siphonage is prevented, for when the various 
fixtures discharge contents into the waste or soil pipes 
air is sucked in from the opening above the roof to re- 
place the partial vacuum caused 'by the descending dis- 
charge of water, and the water seals in the several 
traps are not disturbed. 



DISPOSAL OF WASTE 125 

The various lines of waste and soil pipes connect 
and discharge their contents into the house drain in 
the cellar. This also must be an iron pipe and is 
usually six inches in diameter and even larger when 
it removes the waste from large hotels, apartments, 
factories, etc. The house drain is also trapped just be- 
fore it leaves the house to connect with the street 
sewer, thus preventing sewer gases from entering the 
house. To the inner side of this trap a pipe is carried 
from the house drain to the outside of the building 
to admit fresh air for the ventilation of the various 
lines of waste pipes within the house. In modern 
plumbing the house drain is exposed in order that de- 
fects may be promptly discovered. 

The old method of placing the house drain under 
the cellar floor or constructing it of brick or tile is a 
very insanitary one. The joints of brick or earthen- 
ware drains cannot be properly sealed, and may be 
broken easily and remain undetected for some time. 

Those who are about to rent houses or apartments 
should inquire very carefully concerning the character 
of the plumbing, and obtain reasonable evidence that it 
is of modern construction and in good condition. 

The water carriage, or sewer, system of built-up 
communities is usually under the careful observation 
of municipal authorities. It is the disposal of waste 
matter in the country and small towns, where no sew- 
age system exists and where there is little or no mu- 
nicipal inspection or protection extended, that urgently 
calls for individual attention. 

The primitive method of waste disposal commonly 



126 GOOD HEALTH 

found about farms or country homes consists of a 
privy vault quite close to the house for the deposit of 
human excrement, the slops from the house being 
thrown from the kitchen door. If there are no hogs 
or fowls about the place, to which the waste matter 
from the kitchen or garbage may be fed, this material 
may sometimes be scattered about the premises to be 
disposed of by the sun and air. As a result, very in- 
sanitar}' conditions usually exist, for the waste is 
largely composed of organic matter which quickly de- 
composes and becomes offensive, particularly during 
the warm weather. Furthermore, it becomes a breed- 
ing place for flies and other insects. The unpleasant 
odor of a privy vault may be recognized a long dis- 
tance away. 

The structure which covers the pri\y vault is usually 
most simple and inexpensive; the doors do not close 
properly and the windows consist of openings cut in 
the sides of the building. This condition permits the 
free entrance and exit of flies and other insects, and 
offers little relief from the offensive odors within. 
The danger from this insanitary situation is two- 
fold. Some infectious disease, typhoid fever for 
instance, may affect a member of the household, not 
infrequently in an unrecognized form; or a typhoid 
''carrier" may be present. The infectious germs in ty- 
phoid fever are located in the intestinal canal. Dis- 
charges from the intestines of these persons are depos-^ 
ited in the privy vault and pass through the defective 
walls of the privy vault into the surrounding soil. They 
may reach some nearby water supply, and in this way 



DISPOSAL OF WASTE 127 

transmit the disease. Flies, attracted by any offensive 
matter, are always found in and about the privy vault 
in direct contact with the contents of the vault, and 
with their feet covered with this filth, which often con- 
tains infectious germs, may enter the house and con- 
taminate the food and drink, and in this way also 
spread the infection. 

The privy vault found in the country generally con- 
sists of a ground excavation. Sometimes the floor and 
sides of this vault are lined with brick or cement. 
Even this form of construction is insanitary, since the 
interior lining soon becomes defective and allows the 
escape of filth into the surrounding soil. Furthermore, 
it is practically impossible to clean or deodorize an un- 
derground privy vault. As a matter of fact, there 
is not the slightest justification for the use of such a 
device. 

If no other method of disposing of human excre- 
ment is available, the privy vault used should be an all- 
metal receptacle placed about six inches above the 
ground. This insures an air space around and about 
the receptacle, so constructed that it may be easily 
removed by hand and its contents emptied and buried 
at a point where there is reason to believe there is no 
danger of infection. The receptacle should be after- 
wards cleaned and freely covered with lime and re- 
turned to its place. A wooden receptacle lined with 
some metallic substance is not even as desirable as a 
plain wooden one, for the lining soon becomes defec- 
tive or broken and retains organic matter which other- 
wise might be removed. 



128 GOOD HEALTH 

The privy house and vault should as far as pos- 
sible be made inaccessible to flies and other insects. 
The doors and windows of the privy house should be 
kept carefully screened with wire netting. Ordinary 
mosquito netting and other textile fabrics are practical- 
ly worthless for this purpose, for they cannot be se- 
curely attached and are only of temporary use. 

Contrary to the general belief, it is impossible prop- 
erly to disinfect the contents of a privy vault no mat-^ 
ter what agent is employed, for the disinfectant could 
not be sufficiently incorporated with the fecal matter 
to obtain the desired results. By daily covering the 
mass with lime it may to a certain extent be deodorized. 

To overcome the disadvantages and discomforts of 
the privy vault, particularly at night time and during 
inclement weather, various portable apparatus may be 
purchased for indoor service, such as earth closets. 
With this arrangement, after use a layer of earth kept 
in a nearby receptacle is thrown over the fecal matter. 
This is very effective in preventing an unpleasant odor 
particularly if the bowl or pail is properly emptied, 
cleaned and sprinkled with lime. While these appli- 
ances are comparatively inexpensive and are very use- 
ful, they do not represent modern sanitation. 

Stables and outhouses are usually in a very unclean 
condition, and manure and filth are thrown about in 
heaps and left exposed and uncovered. It is important 
to remember manure is a very common breeding place 
for flies. 

Small cesspools are often dug on the premises for 
the reception of fluid waste from the kitchen. Usually 



DISPOSAL OF WASTE 129 

these cesspools consist of holes dug in the ground into 
which the slops are emptied, the porosity of the soil 
being depended upon to furnish means for its escape. 
Sometimes the cesspools are of larger size, the walls 
being loosely supported with bricks and stones. 

In late years great improvement has been made in 
the disposal of house waste in the country. In the 
m.ore prosperous homes very large and complicated 
cesspools are often constructed for the reception of all 
forms of waste matter from the premises, including 
human excrement, thus rendering privy vaults un- 
necessary. It is a very excellent substitute for the 
water carriage system where the latter is not available. 

It has been shown that when human excrement and 
other forms of organic matter are exposed to certain 
bacteria which are everywhere present, it becomes al- 
most entirely disintegrated and changed to a fluid 
consistence, and in this way is prepared for ground ab- 
sorption. This knowledge has been made use of by 
sanitary engineers in arranging for waste disposal in 
the following manner : 

A water-tight receptacle, known as a septic tank, is 
placed below the ground a short distance from the 
house. This may consist of a simple cask or a large 
and somewhat elaborate cemented receptacle. Into one 
side of this receptacle is discharged all the waste mat- 
ter from the house or other building, including human 
excrement, and here the action of the bacteria takes 
place, and the dissolution of the mass occurs. The re- 
sulting fluid flows from the opposite side of the tank 
and is discharged into and carried away by an under- 



130 GOOD HEALTH 

ground line of pipes. The joints of these pipes are 
slightly separated, so that the fluids passing through 
may gradually escape through these openings. The 
pipes are known as ''purifying'' tile or pipes, and are 
only loosely covered with pieces of stone in order that 
the escape of fluid from the open joints may not be 
interfered with by the soil which covers them. This 
pipe line extends underground probably not more than 
one hundred feet from the building, and is usually so 
constructed at its end that it becomes continuous with 
two or more smaller pipes pointing in different direc- 
tions. Through these branches the fluid waste is finally 
disposed of. It must be remembered, however, that 
although the waste has been broken up and liquefied 
by the bacteria, this process cannot be depended upon 
to destroy all the infectious germs which may be pres- 
ent in the discharged matter. Therefore, the pipe line 
should not be laid in the immediate vicinity of a well. 
Where this system is installed, it is required that there 
shall be a supply tank for the purpose of flushing the 
waterclosets in the house. The details of this are re- 
ferred to in the chapter on Water. 

The manure in stables should be kept in properly 
constructed and closed receptacles which should be 
frequently emptied and cleaned. The latter is a most 
important consideration, for while receptacles are 
necessary to hold manure until it is removed for 
fertilizing purposes, the vaults or boxes in which it 
is stored are not often kept properly closed, and do 
not prevent flies from entering and breeding. A 
germicide which will destroy the fly larvae without in- 



DISPOSAL OF WASTE 131 

juring the bacteria of the manure, which is necessary 
to convert this waste into plant food, was long sought 
for. After careful experimental work, the United 
States Department of Agriculture has found that 
powdered hellebore is a very valuable agent for this 
purpose. One-half pound of this powder to ten gal- 
lons of water is sufficient to treat eight bushels of ma- 
nure. The cost of this would be about six cents. 
The floors of stables should also be kept clean and 
lime freely applied. There is no more effective means 
of rendering the interior of the stables and outhouses 
odorless than by the frequent use of whitewash. 

GARBAGE 

The term ''garbage'' generally refers to the animal 
and vegetable refuse matter from the kitchen. This 
is usually mixed with house waste, such as paper, 
ashes, etc. In cities and large towns garbage is 
collected at certain intervals by the municipal authori- 
ties and disposed of either by burying, by incineration, 
or by the process known as reduction. The lat- 
ter refers to a process whereby the garbage is steril- 
ized by steam and afterwards, by pressure and other 
means, certain products are extracted which are sold 
for various commercial purposes. 

From a sanitary standpoint, there is not the slight- 
est question as to the superiority of incineration over 
all other methods for the destruction of garbage. 
There is no doubt that in the future this will be 
the common practice. Even now cheap and simple 
apparatus may be purchased for household use. The 



132 GOOD HEALTH 

incineration of waste in large buildings such as hos- 
pitals, has been in successful operation for a number 
of years and at a comparatively small expense. Fur- 
thermore, this method of refuse disposal is now being 
introduced into large apartment houses, hotels and in- 
stitutions with the best results. 

When this method of waste destruction has pro- 
gressed sufficiently, the problem of disposing of mu- 
nicipal waste will be largely solved, for much of this 
work will be done within doors by each household. 

In the country garbage is fed to hogs and fowls, 
sometimes buried and often thrown over the ground to 
be disposed of by natural means. Unfortunately, the 
latter is a slow process and in the meantime the gar- 
bage decomposes, becomes offensive and furnishes a 
breeding place for flies and other insects. 

House owners in the country who are sufficiently 
progressive and can afford to install upon the premises 
a septic tank for the disposal of human excrement, 
and other house waste, should also consider favorably 
the purchase of a small and comparatively inexpensive 
incinerator for the destruction of garbage. 



CHAPTER VII 



VENTILATION 



Ventilation relates to the means by which impure 
air is removed from a building and fresh air is intro- 
duced from without for the purpose of maintaining 
proper respiration and comfort. 

In the consideration of ventilation, it must be borne 
in mind that the amount of fresh air required in an 
apartment depends chiefly upon the number and con- 
dition of its inmates. If many persons are present 
the air becomes more rapidly polluted than when only 
a few are to be supplied. 

Furthermore, the amount of fresh air present can- 
not always be determined by the size of an apart- 
ment, for a large room with but a few openings 
supplies less fresh air to its inmates than a small one 
into which fresh air has free access ; although a large 
room is capable of acting as a reservoir for fresh air, 
while a small one can do this only to a very limited ex- 
tent. 

Ventilation has chiefly to do with the cold months, 
for during the warm weather when windows and 
doors are open, a sufficient amount of fresh air is ad- 
mitted without resort to various devices for this pur- 
pose. Ventilation may be classified as natural and arti- 

133 



134 GOOD HEALTH 

iicial. It is chiefly the former which will be discussed 
in this chapter, for artificial ventilation, particularly 
that which is complicated and on a large scale, is 
rather within the province of the architect. 

Nature plays a very important part in ventilation. 
Owing to the laws of diffusion of gases and the 
great pressure of the atmosphere, which has al- 
ready been discussed, it is practically impossible to 
prevent air from entering the interior. It will go 
through any opening, no matter how small; it will 
even penetrate brick and mortar. This, however, does 
not provide adequately for ventilation, and when doors 
and windows are closed, it devolves upon us to ar- 
range for a more generous supply for proper respira- 
tion. 

To secure good ventilation, dwelling houses and 
apartments should as far as possible be located where 
there is plenty of fresh air, away from narrow streets, 
high buildings and offensive trades. Residence in sub- 
urban towns should be encouraged, even if it ex- 
acts time and the discomforts of travel, for the purer 
air in these sections will bring better health and 
longer life. It is particularly necessary to children, 
who, like plants, must have fresh air and sunshine to 
thrive. 

There should be free ventilation in schools and 
workshops, particularly where employees perform 
manual labor, as the exhalations from the skin and 
the mucous membrane under these conditions are gen- 
erally increased, are more rapidly thrown off, and 
more quickly contaminate the air than where but lit- 



VENTILATION 135 

tie physical exertion is required. Besides, when there 
is great physical activity, more oxygen is needed for 
respiration. 

In country houses and private city dwellings and 
in properly situated and arranged apartment houses^ 
the question of ventilation is not particularly disturb- 
ing nor is it true that temporary exposure to the air 
in theaters, halls, subways or public conveyances is in- 
jurious to health. Even though the air is more or less 
impure, it is tolerated for a reasonable period, and is 
not prejudicial to our well-being, except possibly to 
those who are more or less constantly subjected to 
these conditions. 

The unpleasant or serious effects of polluted air 
are more common to those who live in tenement 
houses in closely built-up sections and in residences 
close to factories where the air is contaminated by 
gases and other unhealthful products and to those who^ 
work underground or in improperly constructed or 
ventilated workshops and factories. Long exposure 
to these conditions is likely to render the system more 
susceptible to disease. It is important that those who 
are obliged to live in these unfavorable surround- 
ings should be taught that the best means of overcom- 
ing their bad influence is to remain outside in the fresh 
air whenever it is possible. We may learn much from 
the animals in this direction, as their freedom from 
disease is largely due to the fact that they are more 
or less constantly in the open air. 

Air when warmed becomes lighter, expands and 
. ascends ; therefore, theoretically at least, it will escape 



136 GOOD HEALTH 

more quickly to a higher level. For this reason exits 
for house air are generally arranged in the ceiling or 
upper part of the room through openings which dis- 
charge into the air outside. Cold air is heavier and 
more condensed, and enters more freely a lower level. 
However, in ventilating a house, the inlet for air 
should not be too close to the floor, for it is then 
quite sure to cause drafts. Also, if the inlet is too 
near the ground, the air may be contaminated with 
offensive odors from decomposed organic matter 
which is often found on the surface. 

In arranging for ventilation, incoming currents of 
air should be made to enter about four or five feet 
above the floor and be given an upward turn. In 
this way it not only more effectively purifies the room 
and aids in expelling the foul air, but what is par- 
ticularly important, it largely overcomes the unpleas- 
ant effects of direct currents of air upon the body. 
Direct drafts should be avoided, for they are liable 
to promote colds, probably by rendering more active 
the bacteria on the surface of the mucous membrane 
of the respiratory tract. Not infrequently a cold 
leads to more serious affections. 

If the arrangements are such that incoming air en- 
ters the room in a direct current from an open win- 
dow, its force may be very much diminished by the 
use of fabrics not too closely woven, such as cheese- 
cloth or the finest wire netting, placed over the intake. 
The former material is very cheap and may be pur- 
chased anywhere. A piece of it stretched over a home- 
made frame fitted into a space made by raising the 



VENTILATION 137 

window, constitutes a very simple, effective and in- 
expensive means of ventilating an apartment without 
causing a draft. It also sifts out certain impurities 
in the air. For this reason, the cheesecloth should 
be washed occasionally or renewed. Notwithstanding 
statements to the contrary, drafts should be avoided. 
They may not directly cause colds, influenza, sore 
throats and the like, but they constitute a formidable 
exciting cause. Persons in good health with a splen- 
did resisting power may not be susceptible to these 
conditions or only slightly so. Unfortunately, a large 
percentage of the public is not thus happily protected, 
therefore, ventilation has to be adapted to meet aver- 
age requirements. The lesson we may gain from this, 
however, relates to the inestimable value of maintain- 
ing good health, and thus offering a powerful resist- 
ance to disease. 

Everyone should be interested in home ventilation, 
and should learn to improvise some simple and inex- 
pensive method for this purpose, not alone for the 
sake of economy, but also as a matter of education. 
There are many simple and practical devices for ven- 
tilation which may be purchased for a small sum, 
conforming to the above principles. For instance, a 
wooden panel may be constructed about eight inches 
wide, placed crosswise at the bottom of the window 
and made to slant a little toward the interior. The 
lower sash should be then raised to a point belozc the 
upper border of the panel. The air entering at this 
opening is directed upwards and is much less liable 
to produce drafts. Another very good method con- 



138 GOOD HEALTH 

sists in raising the lower sash a certain distance and 
filling the opening made at the bottom of the window 
with a close fitting panel of wood or other material. 
The separation which then occurs between the lower 
end of the upper sash and the upper end of the lower 
sash, still allows a good free inlet for the air. By 
this arrangement, also, the current will be directed 
upwards. 

These simple principles in a more complicated and 
extended form are applied by engineers in planning 
for the ventilation of great buildings and large dwelling 
houses. Modern methods of artificial ventilation are 
now so perfected that one is not conscious of the con- 
stant withdrawal of impure air and supplying of fresh 
air. 

In discussing the subject of ventilation, great stress 
has been laid upon the importance of the fireplace 
as a means of withdrawing vitiated air from an apart- 
ment. It is true that a draft does occur upwards 
through the chimney connected with the grate by the 
current of the air outside, and that this suction force 
does act as an outlet for inside air ; but fresh air just 
entering an apartment may also be removed in this 
way. Moreover, adverse winds may force a current 
of air down the chimney. It is sufficient to know that 
the use of grate fires is not a modern means of ven- 
tilating a building; besides, grates are not generally 
distributed throughout the house. 

It has been reckoned by sanitarians that under or- 
dinary conditions three thousand cubic feet of air 
each hour for every person present should be admit- 



VENTILATION 139 

ted to a living apartment; even more than this if ac- 
tive exercise is performed. During this time means 
must also be employed to remove the vitiated air. 
It is further estimated that each person within doors 
should be allowed from three to twelve hundred cubic 
feet of air space. Municipal regulations require that 
lodging houses shall supply about five hundred cubic 
feet of space for each lodger; this would mean an 
apartment about seven feet square and ten feet high. 
A much larger amount is called for in hospitals. The 
fact is often lost sight of in preparing municipal reg- 
ulations for the ventilation of lodging houses and 
other institutions where a large number of persons 
are brought together, that notwithstanding the cubic 
space permitted for each lodger is specified, careful at- 
tention is not always given to the operation of the 
various devices installed for the purpose of ventila- 
tion. 

It may be said that the calculations referred to w^ere 
made largely upon the assumption that the compo- 
sition of the air within a building undergoes consid- 
erable change, particularly when many persons are 
present, and that an increase in the amount of carbon 
dioxid takes place, which is responsible for the uncom- 
fortable sensation which occurs in an improperly ven- 
tilated apartment. More recent investigation has 
shown that the composition of the air does not under- 
go any considerable change under the circumstances 
referred to, and that an increase in the amount of car- 
bon dioxid within reasonable limits is not detrimental 
to health. Furthermore, experimental work has 



140 GOOD HEALTH 

proved that the headache, nausea, drowsiness, etc., 
which so commonly affect us in badly ventilated rooms 
are due largely to emanations from the lungs and skin 
and from decayed teeth of those present who are care- 
less about personal cleanliness. In addition to this, 
recent experiments have shown that these unpleasant 
conditions are more pronounced when a high temper- 
ature and moisture are present in an apartment; fur- 
thermore, if the temperature of the room is low, with 
the small amount of moisture which is necessary for 
comfort and proper respiration, even when contami- 
nation of the air is quite pronounced, unpleasant ef- 
fects are not usually noticeable. This goes far to 
prove that it is not so much the change in the compo- 
sition of air within an apartment, as the products of 
decomposition given off from the bodies of those pres- 
ent, a high temperature and increased moisture which 
render an interior unpleasant to its inmates. It is 
generally accepted that a temperature of 70° F. fur- 
nishes comfort and comparative freedom from de- 
pressing conditions. 

The air of the interior can never be made as re- 
freshing and exhilarating as the open air. The lesson 
we should learn from this is that while every effort 
should be made to keep the house well ventilated, it 
is important that a large part of our time should be 
spent out of doors. 



CHAPTER VIII 

HEATING AND LIGHTING 

HEATING 

Artificial heating as it applies to the interior of 
buildings includes the use of fireplaces, gas, oil or 
coal stoves, hot-air, hot-water or steam apparatus and 
electricity. 

Little can be said in favor of coal or wood open 
fireplaces aside from their cheerful appearance and 
the sentiment associated with them. The pleasing 
effect of grate fires is to a large extent now supplied 
by gas logs which emit no smoke or sparks, and can 
be promptly shut off when heat is no longer required. 
Grate fires are inferior for heating purposes and are 
very extravagant. When coal is used, only about 
twelve or fourteen per cent of the heat generated is 
of practical value, and much less where wood is 
burned. An apartment is but imperfectly heated by 
grates, whether the fuel is wood, coal or gas, for por- 
tions of the room some distance from the fireplace 
remain at a much lower temperature than those in the 
immediate vicinity, the temperature diminishing as the 
distance from the grate increases. 

A coal stove cannot be regarded as a sanitary mod- 

141 



142 GOOD HEALTH 

ern means of heating. The warmth is not evenly dis- 
tributed throughout the apartment, and when the stove 
is properly heated, the necessary moisture in the air 
is very much decreased, and the apartment is uncom- 
fortably dry. Besides, particles of organic matter 
floating about the room become charred and offensive. 

The danger attributed to a coal stove is not imagi- 
nary. The combustion of coal forms poisonous gases 
which frequently escape into the apartment, particu- 
larly when fresh coal is added. When stoves are 
used, the danger from this source should be carefully 
guarded against by having the chimney or stovepipe 
damper fully opened in order that the gases may 
quickly escape. It is not an uncommon practice to 
leave the stove door open and to close the damper 
partly or almost entirely to reduce the heat. This 
should not be done, and to prevent it the damper in 
the stovepipe or chimney should be so constructed 
that it cannot be entirely closed. Moisture to over- 
come the dryness caused by this means of heating 
may be supplied by placing a good-sized receptacle 
containing water on the back of the stove or in its im- 
mediate vicinity. 

While gas and oil present about the same objec- 
tions for heating as they do for illuminating purposes 
— that is, unhealthful products of combustion and the 
larger consumption of oxygen — it must be admitted 
that heating appliances or stoves using these agents 
for fuel have within recent years been so far improved 
that with care they may be employed without injuri- 
ous effects. They are better and safer than coal 



HEATING AND LIGHTING 143 

stoves, freer from dirt, and they may be shut off at 
any moment, a very important factor from an eco- 
nomical standpoint. 

Hot-water and steam pipes constitute very satisfac- 
tory and sanitary means of obtaining heat. The 
warmth they supply is more evenly distributed and 
the moisture in the apartment is far less affected 
than when stoves are used. They consume no oxygen, 
and give off no product of combustion to vitiate the 
air. 

Although from a sanitary standpoint hot-air fur- 
naces are inferior to steam and hot water for heating 
purposes, it is not unhealthful if the furnace is prop- 
erly cared for; and if the fresh air and moisture are 
constantly supplied for its operation. 

While at present the use of electricity for heating 
purposes is largely prohibitive on account of its cost, 
it constitutes the most healthful and desirable means 
of obtaining warmth for the interior, and will some 
day be available for general use. 

The proper temperature of an interior, when it can 
be regulated, depends upon the character of the place 
and its inmates. In a workshop where employees are 
engaged in manual labor, the temperature required is 
much below that needed in an apartment where per- 
sons are performing little or no physical exercise. 
Within the house or office, a comfortable tempera- 
ture is 70 "" to 75° F. Small children and old people 
require a somewhat higher temperature than oth- 
ers, and the temperature required during the night 
is less than during the day, provided a person is well 



144 GOOD HEALTH 

wrapped up in bed. This part of the subject will again 
be referred to. 

LIGHTING 

The various means of obtaining artificial light in- 
volves the use of candles, oil lamps, gas and electricity. 
For practical use candles are now employed only 
where other means of lighting are not available and 
for decorative purposes. Even in the most remote 
parts of the world, candles have been largely replaced 
by lamps burning derivatives of petroleum oil. The 
latter method of lighting is too well known to call 
for any special description. Oil gives a soft and sat- 
isfactory light, and is very pleasing to the eyes. The 
objection to its use, particularly in an apartment or 
public place, consists in the large number of burners 
required which call for special care and watching, for 
negligence in this direction may lead to explosions or 
fire, and also in the fact that combustion aids in vitiat- 
ing the air and generates an unpleasant degree of 
heat. The reservoirs of lamps should be constructed 
of metal, and not of glass or china, which is liable to 
crack or break. They should have a broad base for 
safety. A reservoir should not be filled up to the top 
nor should the oil be allowed to burn low, for when 
the oil in the reservoir is reduced in amount, there 
is sufficient room for gases to form, which may be ig- 
nited by the flame through defective wicks at wick 
openings or by blowing down a chimney, with a possi- 
ble resulting explosion. 

A wick should be soft, should fit perfectly to the 



* HEATING AND LIGHTING - 145 

wick tube and should be frequently removed and a 
new one substituted, in order that a proper length may 
be maintained. When lighted, the wick should at first 
be turned down and then slowly raised. A lamp 
should not be blown out; this is not necessary if it is 
properly supplied with an extinguisher. If the lat- 
ter is not present, the wick should be carefully turned 
down until there is only a small flame, and a cover- 
ing or cap placed on top of the lamp chimney which 
will prevent the entrance of air necessary for com- 
bustion. It is a dangerous practice to move lighted 
lamps about. It may be properly said that the best 
way to prevent danger from oil lamps is to purchase 
a first-class modern apparatus, instead of a cheap one 
which is inefficient and dangerous. 

The artificial lights most generally used at the pres- 
ent time are furnished by coal, gas and electricity. 
While gas has many advantages over oil as an illumi- 
nant it is not without its faults and dangers. Like 
candles and lamps, it gives off various products of 
combustion and consumes a large amount of the oxy- 
gen of the air, each burner probably requiring more 
than an adult human being. The danger resulting 
from the use of gas for artificial lighting is usually 
due to carelessness. If gas is not properly turned 
off, the air in the apartment is rendered unfit for 
respiration and explosions may occur. As far as 
the selection of proper apparatus and burners is 
concerned, this may be safely left in the hands of 
first-class dealers in fixtures ; there is no economv in 
purchasing cheap or imperfect illuminating apparatus. 



146 GOOD HEALTH 

Electric light constitutes the most sanitary, effective 
and practical illuminating agent which can be em- 
ployed. It absorbs no oxygen from the air, gives off 
but little heat and is devoid of danger except that 
which may occur as the result of improper wiring or 
insulation. From a sanitary standpoint, it would be 
difficult to overestimate the value of electricity for 
lighting purposes. Before it was generally employed 
for this purpose, it was exceedingly difficult to ven- 
tilate theaters or other buildings where many were 
congregated and where gas and oil were used in 
large quantities for lighting purposes. 



CHAPTER IX 



PERSONAL HYGIENE 



Personal hygiene has to do with the means by 
which our individual heahh is preserved, chiefly 
through the proper maintenance of the resisting power 
of the body. The value of the latter cannot be over- 
estimated, for upon it largely depends the prevention 
of disease. It is important to bear in mind that proper 
care of the body does not mean that we shall be de- 
prived of the pleasure of life but only that we shall 
maintain in good condition the wonderful machine 
which is placed in our keeping. This is all that nature 
exacts from us. Essential factors concerned in per- 
sonal hygiene are : proper food and drink, exercise, 
cleanliness of the body, sleep, appropriate clothing, and 
temperance in all things; the last being a most neces- 
sary consideration. 

FOOD AND DRINK 

The importance of guarding carefully the digestive 
and alimentary tract against improper food and espe- 
cially overeating, has been referred to in the chap- 
ter on Food. A mixed diet composed of plain, simple 
and easily digested substances constitutes the pro^>er 
and natural means of securing nourishment, and knaves 

147 



148 GOOD HEALTH 

unimpaired the various organs concerned in this im- 
portant function. The necessity for food of this char- 
acter and the ease with which its digestion is normally 
accomplished have already been discussed. Advanced 
civilization has to a great extent destroyed the desire 
for simple food, and has substituted a taste for rich 
and indigestible dishes which is dearly paid for in 
more ways than one. 

Probably nothing contributes more to the unpleasant 
and serious disturbances of the digestive tract than a 
frequent indulgence in formal and public dinners, for 
at these functions hosts and hostesses vie with one an- 
other in placing before their guests food and drink in 
great variety and in most tempting and indigestible 
forms. If reformation in this direction could be ac- 
complished, and if instead of this display a few well 
cooked and nourishing articles could be presented, and 
the entertainment depend upon the social element 
rather than food, it would furnish an example, the 
value of which, as far as correcting errors of diet goes, 
-would be difficult to overestimate. 

It is not intended in this book to discuss in detail al- 
coholic drinks and the unpleasant and dangerous re- 
sults which follow their use. Addiction to the use of 
alcoholic drinks weakens the resisting power of the 
body which is essential to the preservation of health. 
The ability of the organism to counteract the in- 
jurious effects of alcohol is gradually worn down and 
the poisoning process makes such inroads as to render 
ineffective the wonderful protective mechanism of the 
body. This fact is well established. Liquor-drink- 



PERSONAL HYGIENE 149 

ing is largely a matter of habit without reasonable 
justification. Besides, it is associated so often with 
unpleasant public demonstrations that it has become- 
familiar to all and consequently has overshadowed the 
dangers of intemperance in other directions. The 
public does not appreciate this, for many of those wha 
regard with horror the use of alcohol are gluttons 
at the table and often die from causes superinduced 
by overeating. 

Coffee and tea are delicious beverages and are used 
throughout the world, and there is no good reason to 
believe that when taken by healthy adults in a moder-^ 
ate amount any well defined unpleasant results will- 
follow. However, when intemperately used, the ner- 
vous system is often seriously involved. 

In late years, tea drinking has been introduced into- 
this country as a social institution and, like all fads, is 
being overdone. A serious factor in connection with 
the tea and coffee habit is their increasing use among^ 
children who drink them daily and depend upon them. 
for their stimulating effects. Children pass through a 
formative stage during which the various tissues of 
the body develop and reach their growth. As above 
stated, coffee and tea, as well as tobacco and alcohol, 
seriously affect the nervous system, particularly of 
young children, and there is no doubt that in persons 
of this age these agents are not only responsible for 
temporary injury but lay the foundation for more 
serious affections. Parents are largely responsible for 
the tea and coffee habit among children, for it is 
usually contracted at home. 



ISO GOOD HEALTH 

EXERCISE 

Exercise is necessary for many reasons: It aids 
digestion, assists in securing proper sleep and helps to 
maintain the various functions of the body. Without 
it the lungs are not properly inflated and, when this is 
the case, are far less able to resist the attack of cer- 
tain diseases which commonly affect these organs — 
tuberculosis, for instance. Besides, if muscles are not 
properly exercised, they are apt to become reduced in 
size and importance, for nature does not look indul- 
gently upon the support of tissues which perform little 
or no work. 

The most important function of exercise, the adjust- 
ment of the circulation, is not generally understood. 
This is brought about largely by the activity of the 
great muscular system which goes far to relieve con- 
gested centers, such as the brain, liver and other or- 
gans. For this reason, exercise is particularly val- 
uable for the so-called brain workers who during the 
day and very often at night are engaged in work 
which calls for undue activity on the part of the brain. 
To provide for this, an increased supply of blood is 
required. If this pressure continues too long the 
small blood-vessels of the brain become dilated and 
stretched, and are very apt to undergo degenerative 
changes. Later in life this condition leads to serious 
results, the commonest of which is hemorrhage of the 
brain, or apoplexy. 

Proper exercise relieves this overcharged condition 
of the brain by drawing a large amount of blood to 
the surface of the body. Other congested organs, par- 



PERSONAL HYGIENE 151 

ticularly those of the digestive tract — the Hver, for 
instance- — are similarly relieved by exercise; and it 
may be said that upon this simple means of adjusting 
the circulation largely depends the preservation of 
health and the prolongation of life. 

Walking is the natural and by far the most valuable 
form of exercise. It is available for persons of any 
age and any class ; it costs nothing and requires practi- 
cally no equipment. While horseback riding is very 
pleasant and exhilarating and other forms of exercise, 
such as gymnasium work, tennis and rowing, are of 
value in their way, they are far inferior to walking 
as far as the adjustment of the circulation is 
concerned. 

Comparatively few who reside in cities can afford 
the luxury of horseback riding. It requires consid- 
erable preparation, and even among those who need 
not consider the expense involved, this form of exer- 
cise is usually indulged in only at irregular intervals. 
There are men and women who in advanced life se- 
lect horseback riding as a means of overcoming cor- 
pulence and other unpleasant conditions commonly due 
to sedentary habits or overindulgence at the table. 
Many of these persons have organic or other affections 
of the pelvic content or other physical impairments 
which should contraindicate horseback riding. It is 
important also to mention that these persons are often 
very careless about using a proper support for the ab- 
dominal walls, particularly during exercise — a very 
important consideration. Furthermore, persons of 
advanced age should not take regular active exer- 



152 GOOD HEALTH 

cise of any kind without the approval of a physician. 

The gymnasium has its value for athletes and for 
those who desire to develop the muscular system, but 
it is indoor exercise and is hence robbed of half its 
value. This form of exercise requires apparatus and 
is not adapted for the general public; besides, it is 
more or less violent and appropriate only for those 
who are comparatively young. This statement in a 
general way applies to the innumerable exercising ap- 
paratus manufactured for home use, the value of 
w^hich is limited, that is, for the use of those who are 
unable to secure the benefits of outdoor exercise. 

Rowing and tennis are healthful forms of outdoor 
exercise, but are available at only certain seasons of 
the year ; besides, they are not suitable for all ages. 

The game of golf, which has become very popular 
in this country, is practically walking made pleasant 
and interesting, and no other kind of exercise ever 
practised has contributed so much to the repair of 
health, particularly in persons with overtaxed brains 
and sluggish digestive apparatus. It is suitable for 
persons of any age but unfortunately it is not within 
the reach of all. 
■' A careful analysis of the subject of exercise will 
prove that it is regular, and not occasional, exercise 
which is required to maintain health, and there is no 
form which equals a daily walk in the open air. If 
time cannot be found for exercise during the day it 
should be taken after sundown, for there is no truth 
in the belief that night air is unhealthful, although 
it may not give the full value and stimulating effect 



PERSONAL HYGIENE 153 

of exercise taken during the daytime. It was formerly 
believed that night air bred malaria; now we know 
that this disease is transmitted from one person to 
another only by a variety of the mosquito known as 
the Anopheles. 

The benefit obtained from walking is substantial in 
proportion to the regularity with which it is per- 
formed ; from four to six miles may be regarded as an 
average daily walk for an adult, and the result is far 
more effective when the entire distance is covered at 
one time. A good pace should be taken, although it is 
not advisable that one walk too fast. The shoulders 
should be erect in order that proper respiration may be 
sustained; in this way the lungs are well inflated and 
ventilated. 

A short walk is not of much value in relieving the 
congestion of internal organs, for the exercise ends 
before a sufficient amount of blood is withdrawn from 
these centers; neither is a long walk in piecemeal as 
apt to secure the desired result as a long walk without 
interruption. 

For the first mile or so of the walk a person in need 
of exercise is not conscious of any appreciable change, 
but if the walk is continued mental weariness is quite 
apt to disappear and is succeeded by a feeling of well- 
being as the blood is brought ''below the belt'' — a term 
which may be used to indicate that the circulation has 
been largely diverted from the internal organs, partic- 
ularly the brain, which is now passing to a period of 
rest. 

It is not good to take a long brisk walk directly after 



154 GOOD HEALTH 

a full meal because an increased quantity of blood is 
then needed for digestion, and too much exercise may 
interfere with this important function. A little exer- 
cise, however, at such a time is not harmful. 

Persons under a prolonged mental strain commonly 
experience a sense of fatigue. This is as a rule a 
mental and not a physical condition, and the proper 
remedy for it is exercise in the open air and not rest. 
Too much importance cannot be attached to this state- 
ment, for those affected in this way Usually seek to 
overcome this uncomfortable feeling by rest or stimu- 
lants, the reverse of what is required. 

Walking is more or less monotonous and uninterest- 
ing if done solely for exercise, particularly if one 
walks alone. To overcome this pedestrian clubs are 
often formed. These, however, do not provide regular 
daily exercise; besides, there are many who do not 
care to walk under these conditions. A more pleas- 
ant and practical arrangement is for two or more to 
walk after the day's work is over. At this time exer- 
cise is of great relief to both mind and body. 

There are many whose work consists largely of man- 
ual labor and others who are constantly moving about 
in the open air; in other words, there are various 
vocations which require physical activity. Those en- 
gaged in these pursuits have wholly or in part com- 
plied with nature's demand for exercise. It is rather 
those of sedentary habits, and more particularly brain 
workers, who are closely confined during the day and 
often a large part of the night, year in and year out, 
to whom the urgent need of walking especially applies. 



PERSONAL HYGIENE 155 

Such persons are more often found in cities and con- 
stitute a large part of the city population. They do 
not often take sufficient or continued exercise, nor do 
they appreciate the importance of it, as far as the 
preservation of their health is concerned. 

There are very few in any station of life who, if 
they determine to do so, cannot devote at least one 
hour each day to walking, and it will not take long to 
prove to those who undertake this the great value of 
open air exercise. 

Contrary to the general belief, exercise is not inju- 
rious during the warm weather. It is in fact essential 
to health, except possibly during very hot spells. No 
better or more striking illustration of this can be given 
than in the instance of baseball players. These men, 
during the hottest part of the day and for two or three 
hours, are continuously engaged in the most active 
form of exercise, and it is rare that cases of heat pros- 
tration occur among them. This simply means that 
by careful training and proper care of the body, a per- 
son can develop a resisting power which is little af- 
fected by climatic conditions. This again serves to 
remind us that the preservation of health is largely in 
our own hands at any season of the year. 

BATHING 

Bathing in some form is probably practised in 
every part of the globe, even in uncivilized countries, 
for either cleanliness or pleasure. There is a great 
difference, however, in the modes of bathing among 
the various classes of people throughout the world. 



IS6 GOOD HEALTH 

It has been said, and not without some truth, that 
the degree of civilization attained by a people is 
indicated largely by the attention given to personal 
cleanliness. As a rule the public takes little account of 
the real benefits to be gained in this way or the pleas- 
urable and satisfactory means by which they may be 
obtained, although it is important that this should be 
well understood. 

The skin, through millions of little ducts, is con- 
tinually discharging waste matter from the body. The 
surface of the skin is also supplied with a scaly layer 
and a coating of fatty matter which are being con- 
stantly renewed and thrown off. If these substances 
are not promptly removed from the skin, particularly 
in warm weather, they decompose and become very 
offensive, and the function of the skin is more or less 
impaired. More important still, if poisonous products 
formed in the body are not promptly eliminated 
through the kidneys and skin, uncomfortable or serious 
results are sure to follow. 

The waste matter from the skin becomes particu- 
larly offensive in parts of the body where surfaces are 
brought together and where evaporation cannot readily 
take place, as under the arms, between the toes, etc. 
While this condition may be tolerated by persons who 
are careless regarding the proper care of the body, it is 
exceedingly trying to those who are in close proximity 
to them. No amount of clothing, powders or perfume 
will mask the disagreeable odors of decomposition. To 
prevent this unpleasant condition and to assist nature 
in the prompt excretion of waste substances a daily 



PERSONAL HYGIENE 157 

bath is desirable, particularly in the warm weather, for 
then the skin is more active, the amount of excretion 
greatly increased and decomposition more rapidly 
takes place. 

The frequency with which a person should bathe to 
insure cleanliness depends largely upon the character 
of the work performed, climatic conditions and other 
factors. While the old time weekly bath may in a 
way answer the purpose of cleanliness during the cold 
weather, it does not maintain adequately a clean and 
pleasant condition of the skin during the summer. 
Even then a daily bath and the free use of soap and 
water are not always sufficient for this purpose, partic- 
ularly about the parts which are in close contact. 

While a tub bath is useful for the weekly scrubbing, 
it is not as satisfactory or stimulating as the shower 
bath, and there is no doubt that in the future the lat- 
ter will replace the tub for bathing purposes. 

It is true that not everyone has a tub or shower bath 
at his disposal, but everyone can obtain a large sponge 
at a moderate price, plenty of soap and an ordinary 
wash tub or some other simple receptacle. Water is 
always available, and with this outfit the skin may be 
kept in good condition. Rubber bath tubs may be pur- 
chased at a comparatively low price. These can be 
folded up, they occupy little space, can easily be car- 
ried about while traveling, and oflfer a very excellent 
substitute for the ordinary bath tub. Whatever form 
of bath is selected, it must be remembered that the 
skin cannot be properly cleaned without the use of 
soap. 



158 GOOD HEALTH 

The temperature of the bath is an important consid- 
eration. The very young, the very old and invalids are 
not proper subjects for cold baths at any time. The 
shock which follows the sudden reduction of tempera- 
ture of the surface of the body is not usually suc- 
ceeded by a prompt and healthful reaction in these 
cases, and not infrequently unpleasant results ensue. 
Neither is the practice of plunging into a tub of cold 
water in the morning, particularly in the winter, to be 
recommended to anyone. While there are persons 
who apparently enjoy this form of bathing, it is quite 
probable that sooner or later it becomes detrimental 
to health. 

A warm bath is valuable for cleansing purposes, but 
it is soothing rather than stimulating, and renders a 
person quite susceptible to a lowered temperature. 
Therefore, during cold weather warm baths should be 
taken at bedtime, for outside exposure after a warm 
bath would very likely be followed by a cold or some 
more serious affection. During the heated term, warm 
baths may be commonly resorted to during the day for 
cleansing purposes without any ill effects. 

The most valuable, stimulating and pleasurable daily 
bath for a person in good health is a very warm 
shower bath of short duration followed by a cold 
shower for the fraction of a minute only. In this way 
the surface of the body having been warmed, the cold 
shower produces less shock than if the warm water 
had not first been applied. The cold shower alone is 
not as acceptable, and certainly not as pleasant and 
stimulating as the combined shower. This bath should 



PERSONAL HYGIENE 159 

be taken upon rising in the morning and followed by 
a brisk rub with a coarse towel. 

Turkish and Russian baths are not required to main- 
tain a good, healthy condition of the skin. They are 
taken rather for their agreeable effects, and in some in- 
stances for their remedial action in certain conditions 
of disease. Invalids and persons with organic trouble 
should not take these baths except with the approval 
of a physician. 

A bath should not be taken within two or three 
hours after a meal. If the surface of the body is sub- 
ejected to either extreme of temperature after digestion 
has begun, the circulation of the blood in the alimen- 
tary tract, which during meal time is adjusted for di- 
gestive purposes, is affected sometimes with disagree- 
able results. 

Both fresh and salt water open air bathing must be 
placed in the list of sports and pleasures. It is a mis- 
taken idea that this kind of bathing is uniformly a 
healthful practice, for it is not. Those who enjoy 
swimming invariably remain in the water too long. In 
case of young persons the ill effect of this is not so 
apparent, but older persons or very young children are 
very apt to suffer from exhaustion and extreme cold- 
ness of the surface. Open air bathing, to be quite pru- 
dent, should not last more than ten or fifteen minutes, 
and should not be indulged in soon after a meal. 
Aside from the depression which may occur as a vio- 
lation of this rule by interfering with digestion, there 
is little doubt that cramps, which often occur dur- 
ing swimming and which are not infrequently accom- 



i6o GOOD HEALTH 

panied by serious and even fatal results, are due to 
digestive disturbance following the shock caused by 
the reduced temperature of the water. 

The blueness of the skin and the shivering, which 
are so commonly noticed among open air bathers, can- 
not be regarded as evidence that this exposure is con- 
ducive to health, although at the time it may be fol- 
lowed by no unpleasant symptoms. One thing is quite 
certain : this form of bathing is not desirable or health- 
ful for very young children or for those feeble in 
health or advanced in years. 

There is no doubt that the depression and languor 
which often affects those who visit the seashores or 
large bodies of water where swimming is a feature are 
frequently due to prolonged open air bathing. This 
condition often persists for some time after a person 
has returned home. Young children are very often 
improperly exposed in this manner. 

TEETH 

The care of the teeth is an exceedingly important 
element in the preservation of health. Aside from 
the unpleasant odor and appearance associated with 
decay, imperfect teeth or an insufficient number of 
them sooner or later lead to impaired digestion. The 
public is not fully conscious of the possibilities of dan- 
ger in this direction, or the extent to which it pre- 
vails. 

A recent report concerning the work of dental 
clinics in New York City shows that of 1,694 children 
examined, only eleven had normal teeth. This at least 



PERSONAL HYGIENE i6i 

indicates the necessity of more careful attention to 
the subject. Its importance relates more particularly 
to early childhood, and it is wrong for parents or 
guardians to omit the closest observation of a matter 
which will have such a serious effect upon a person's 
health, comfort and appearance. Children should be 
taken regularly to a dentist, not only to deal promptly 
with decay when it exists but to prevent this condition. 

Recent investigation has conclusively shown that 
diseased teeth, tonsils and other centers of infection 
are commonly responsible for rheumatism, a very dis- 
tressing and often serious malady. It would be diffi- 
cult to overestimate the value of this knowledge, for it 
places in the hands of the public, as well as the med- 
ical profession, means by which this disease may often 
be prevented. 

The teeth should be thoroughly brushed upon rising 
in the morning and at bedtime with a medium-sized 
and moderately stiff brush for the purpose of remov- 
ing particles of food. Powder specially prepared for 
cleansing the teeth may be purchased at a very low 
price. Precipitated chalk, which is good for this pur- 
pose and very inexpensive, can be bought at any drug- 
store. Special care in the cleanliness of the mouth 
should be observed by those who have artificial teeth. 

The too frequent use of acid substances, such as 
lemons and grapefruit, is more or less injurious to the 
teeth. The bad eft'ect of these articles may be largelv 
neutralized if the mouth is afterwards rinsed with a 
solution of bicarbonate of soda, about a quarter of a 
teaspoonful to a glass of tepid water. This solution 



i62 GOOD HEALTH 

may also be used as a mouth wash to dislodge moFe 
thoroughly particles of organic matter. 

EYES 

The eyes, like the teeth, do not as a rule receive 
proper attention, and unless some urgent sign or symp- 
tom of defective sight or disease appears, a careful 
examination is rarely made. Great care should be 
taken, particularly with children, to detect any devia- 
tion from the normal conditions, in order that it may 
be promptly rectified and long suffering and possibly 
loss of sight prevented. 

Continued headache, dizziness, nervousness and im- 
paired digestion are not infrequently caused by de- 
fective eyesight, and are often promptly cured by suit- 
able glasses or some simple form of treatment 

HANDS AND FEET 

The hands and feet need very careful attention. In 
the army regulations of some countries may be found 
the most minute instructions as to the care of the feet, 
for if they are not kept in good condition the soldier 
becomes unfit for service, as his marching ability is 
seriously impaired. Neglect and lack of cleanliness 
of the feet are often due largely to the fact that they 
are not exposed to view. The feet should be daily 
washed and carefully dried, particularly between the 
toes. Care of the feet in childhood usually insures a 
shapely foot in the adult. 

Corns, bunions and ingrowing nails should be 
promptly and properly dealt with. Sometimes these 



PERSONAL HYGIENE 163 

conditions require surgical treatment. In this case a 
physician should be consulted, for the danger of in- 
fection from this source must not be forgotten. Tight 
and ill-fitting shoes which are sure to deform the feet 
must be carefully guarded against, and stockings 
should be frequently changed. 

No detail of personal hygiene makes so favorable 
an impression upon others as clean hands and well 
trimmed nails. Attention to this matter creates a most 
favorable impression when seeking employment. A 
nail file may be purchased at a very low price, and with 
the vigorous use of a good serviceable nail brush two 
or three times a day, the hands may be kept in a very 
presentable condition. The nails may be polished in 
the palms of the hands with a little powder to create 
friction. The care of the nails is not only desirable for 
appearance's sake, but if they are not properly cleaned 
it is believed that they 'become the repositories for 
germs. 

SLEEP 

Sleep is the natural means of securing rest for the 
mind and the body. The number of hours necessary 
for this purpose depends largely upon occupation and 
general condition of the individual. 

Persons actively engaged in brain work or physical 
exercise require more sleep than those of inactive hab- 
its, and children need more sleep than adults. No 
definite rule can be prescribed as to the proper length 
of rest period, although in a general way it may be 
said that adults should have from six to eight hours* 
sleep, and children eight to twelve hours'. Sleepless- 



i64 GOOD HEALTH 

ness and insomnia are very common affections and are 
not always difficult to overcome if the cause is known. 

Sleep, which is nature's restorer, will occur unless 
ill health or some temporary worry or excitement pre- 
vents it Therefore, if insomnia exists, its cause 
should be ascertained and removed rather than the 
wakefulness itself dealt with. Nothing is more inju- 
rious than a resort to drugs for this purpose. Medi- 
cines which cause sleep almost always weaken the 
heart and depress the general system, and in various 
ways may delay a return to the normal condition of 
health, which is the object in view. Moreover, the use 
of drugs to produce sleep is very apt to lead to a dan- 
gerous and pernicious habit, and too much cannot be 
said in condemnation of the many remedies which are 
advertised for this purpose. A person who suffers 
from insomnia for a protracted period is not in a nor- 
mal condition of health and should consult a physician. 
He should not resort to the use of so-called sleep- 
producing agents. 

During sleep the heart and lungs are less active, and 
under these conditions it is essential that the dimin- 
ished amount of air consumed should be as fresh as 
possible. Free ventilation during sleeping hours is 
therefore of the greatest importance in order that suf- 
ficient oxygen for respiration may be obtained. Out- 
side air, particularly when cold, supplies a greater 
quantity of oxygen in a given amount than that within 
the house. Instinctively a person whose respiration 
is suddenly restricted will open the windows to breathe 
the outside air. 



PERSONAL HYGIENE 165 

The habit of sleeping out of doors or with the win- 
dows of the apartment wide open is now largely prac- 
tised. It must be remembered, however, that notwith- 
standing the desirability of plenty of fresh air in the 
sleeping room, drafts must be avoided, and though the 
head is exposed, the body should be kept warm. In 
certain diseases, particularly in tuberculosis of the 
lungs, fresh air has a special and largely curative 
value. While free exposure to the outside air is very 
important in this affection, it is not required that 
healthy persons should provide for more than a well 
ventilated sleeping room. Furthermore, it must be re- 
membered that persons suffering from certain condi- 
tions of the throat, nose and ears, and those in feeble 
health or advanced in years are often made uncomfort- 
able and unfavorably affected by too much exposure to 
cold air and drafts during the night. While the sleep- 
ing room should be well ventilated it is very desirable 
that the dressing or bathroom be comfortably warm 
in order that the exposed surface of the body upon 
rising is not chilled by the greatly reduced tem- 
perature. 

A word may be said regarding the equipment of 
the bed. A reasonably hard mattress is best to sleep 
upon. A feather bed should not find a place in any 
home. During sleep the pressure of blood in the brain 
is diminished in order that this organ may obtain rest. 
Elevation of the head not too high while in bed aids 
this; therefore pillows are used. This habit is so gen- 
erally accepted that it goes far to establish the need of 
support of the head during sleep. Although some per- 



i66 GOOD HEALTH 

sons sleep without pillows apparently with comfort, 
this is individual preference and does not prove it to 
be a good healthful course for everyone to follow. 

CLOTHING 

While from a general standpoint the need of cloth- 
ing is too well understood to call for comment, the 
importance of wearing garments suitable for the vari- 
ous climatic conditions is not so well appreciated. 

The materials usually employed in the manufacture 
of clothing are linen, cotton, wool, silk and fur. Cotton, 
and linen are good conductors of heat and cold ; that is, 
the warmth of the body passes quickly through these 
fabrics into the outer world and the cold enters from 
w^ithout, therefore they do not offer the protection af- 
forded by wool and silk which are very poor conduct- 
ors. Besides, cotton and linen are not so hygroscopic 
as wool and silk; that is, the individual fibers of the 
former materials do not absorb and give off water as 
slowly as in the case of wool and silk, but allow it to 
evaporate quickly. As a very familiar example of this, 
when cotton or linen underclothing becomes wet from 
perspiration in the summer evaporation takes place so 
rapidly that the body becomes quite cold, whereas if 
wool is used, the chilling takes place more slowly. 
Silk has to some extent the properties of wool just re- 
ferred to, and is sometimes used as a substitute for it. 

In this country fur need only be considered as an 
•outer garment for extremely cold weather, while in 
sections of the world where the temperature is con- 
stantly very low it is used as a common article of cloth- 



PERSONAL HYGIENE 167 

ing. The value of fur lies in its impermeability to cold 
and winds. The great protection against cold fur- 
nished by a fur coat is due not only to the skin sur- 
face, but also to the very large amount of air contained 
in the meshes of the fur. Air is a very poor conductor 
of heat and cold, and for this reason loosely woven 
fabrics which contain air in their meshes are warmer 
than those which are closely woven. Two or three 
layers of clothing are warmer than one of equal thick- 
ness because there is air between the various layers. 
This explains why several layers of paper wrapped 
around the body or placed over the bed covering is a. 
valuable protection against the cold. In emergencies, 
newspapers may be used for this purpose. 

All garments used for clothing should be porous to 
admit the air; otherwise the function of the skin is ma- 
terially interfered with. For this reason mackintoshes, 
and leather or rubber clothing are not good or health- 
ful for continued wear. 

The choice of clothing depends largely upon climatic 
conditions. The selection for the cold season gener- 
ally includes a change both in the outer and under gar- 
ments and the addition of great coats and wraps for 
outside exposure. 

It would be difficult to describe the numerous styles 
and fabrics used for underwear, the value of many of 
them being largely theoretical. While various articles 
are recommended, there is but one material which from 
a practical and scientific standpoint is entitled to gen- 
eral approval for winter underwear, and that is wooL 
Wool ofifers the best protection against cold, for it is 



i68 GOOD HEALTH 

a very poor conductor of heat. While it helps to 
retain the body heat it also aids very effectively in 
preventing the chilling effect of the external tempera- 
ture upon the body. Cotton is the least valuable for 
this purpose, while silk probably occupies a position 
between wool and cotton. Some wear cotton under- 
clothing throughout the year apparently with comfort ; 
yet this does not prove that it is of the same value as 
wool for general use. 

It is not necessary that undergarments should be 
composed entirely of wool. While a mixture of 
twenty-five per cent' of cotton does not materially af- 
fect the protective value of the material, it renders it 
more agreeable to the skin and prevents excessive 
shrinking during the process of washing. This latter 
result, it must be observed in passing, has been largely 
overcome by modern laundry methods. 

Not only the material, but the weight, of the winter 
undergarments should be considered. It is a common 
practice to have those of but one thickness for winter 
use, whereas everyone should be supplied with two 
weights to insure comfort. During the winter the 
weather often becomes mild and continues so for a 
number of days, and if the underclothing is too heavy 
the skin becomes moist and tender and renders a per- 
son more susceptible to colds. 

Colored underclothing has no special value and 
should not be used, particularly in cheap material, for 
the dye is very apt to come off and produce more or 
less irritation of the skin. 

Upon the approach of winter it is the custom to sub- 



PERSONAL HYGIENE 169 

stitute heavier outer clothing for that worn during the 
summer. While it is important that serviceable woolen 
undergarments should be provided for cold weather, a 
change in the weight and material of the outside cloth- 
ing is not only unnecessary but is responsible for much 
discomfort and ill health. 

During the winter, particularly in cities and towns, 
persons usually remain indoors not less than twenty 
out of twenty-four hours, often in apartments, work- 
shops or offices where the temperature is too high ; 
sometimes reaching eighty or more degrees. This is 
practically summer heat, but without the fresh air 
which is available during summer, for the windows are 
kept carefully closed. In these insanitary surroundings 
a person who is too heavily clad is not only made un- 
comfortable, but, as stated above, the skin is very apt 
to become moist and tender and in this condition very 
sensitive to the lowered outdoor temperature which is 
often thirty or forty degrees below that of the interior 
of the house. There is no doubt that exposure to these 
rapid and extreme variations of temperature under 
the conditions just referred to, is often directly respon- 
sible for the different cold weather ailments. 

The fact is that during the cold weather heavy and 
uncomfortable outer garments are worn within doors, 
in order to afford protection against a brief period of 
exposure upon going outside ; whereas our dress 
should rather be adjusted to the temperature of the 
interior, and then heavy overcoat or ulster added upon 
leaving the building. These wraps are made to cover 
almost the entire body. 



170 GOOD HEALTH 

It is far more comfortable and reasonable and more 
conducive to health to wear outer garments of the 
same texture and weight throughout the year, except 
possibly in midsummer when clothing made of very 
thin material of ''tropical weight" is appropriate. 
Those who have adopted this logical mode of dress 
are fully convinced of the comfort and protection 
which it affords, particularly within doors. 

It is also important that special protection be pro- 
vided for the feet during the cold and wet weather, 
for carelessness in this direction is a common cause of 
colds, sore throats and other uncomfortable and dan- 
gerous affections. Boots and shoes, which are really 
waterproof exist chiefly in the imagination, and offer 
little or no protection. Everyone should be provided 
with rubbers and overshoes, and should use them 
when the streets are damp, wet or covered with 
snow. Unfortunately, this very valuable form of pro- 
tection is not popular, at least in this country; besides, 
complaint is often made that they cause the feet to 
sweat. This complaint is largely groundless, for rub- 
bers do not interfere with comfort if they are promptly 
removed upon entering the house. Proper protection 
for the feet and a moderate temperature in apartments 
during the winter months are, as far as the preserva- 
tion of health is concerned, far more important than 
the public realizes. 

In selecting appropriate clothing, particularly for 
warm weather, a knowledge of the heat-absorbing 
qualities of the different textile fabrics is of value. It 
seems to be well proven that white attracts the heat 



PERSONAL HYGIENE 171 

less than colors, and is therefore the coolest for sum- 
mer wear, while black is the warmest. For this pur- 
pose custom and experience have so well indicated the 
dress which is most comfortable during the warm 
weather, that there is little to be said on the subject. 
It is not generally known, however, that thin under- 
garments containing some wool are actually far more 
agreeable than those composed entirely of cotton, for 
there is far less chilling effect when they become wet 
with perspiration. 

Undergarments must be changed frequently, for 
when they become soaked with perspiration containing 
decomposed matter from the skin, they are sure to be- 
come offensive and retain an unpleasant odor. Dry- 
ing and airing does not remove the odor. 

Variations in climatic conditions not only require 
change in our mode of dress, but in eating and other 
details connected with the care of the body. It is quite 
true that a young person in good health would probably 
be able to pass through the entire year with but little 
or no change of dress, bathing, exercise and food, and 
still avoid any unpleasant consequences. On the other 
hand, as we grow older or where sickness occurs, or 
where the rules of health are violated, the resisting 
power of the body becomes lessened and must in vari- 
ous ways be compensated for. 

CONSTIPATION 

An important detail connected with the preservation 
of health which receives far too little attention is the 
proper care of the bowels and the avoidance of con- 



172 GOOD HEALTH 

stipation. Constipation leads to all sorts of unfavor- 
able conditions, chiefly the absorption of poisonous 
products from the intestines. 

The cause of constipation in the absence of organic 
disease is due chiefly to the loss of tone and activity 
of the muscular coat of the intestines, the function of 
which is to keep the intestines active during the diges- 
tion of food and to remove from the body waste mat- 
ter resulting largely from digestion. Constipation 
is usually the result of sedentary habits, improper food 
and intemperance in eating and drinking. Unless this 
subject is given proper consideration in early life, 
chronic constipation, which is exceedingly difficult to 
overcome, frequently follows. 

As constipation, particularly in an obstinate form, 
is not a normal condition, it may usually be avoided in 
a healthy person. In general the preventive measures 
relate to the proper care of the body, or personal hy- 
giene, especially the use of suitable and simple food, 
sufficient water and, most important of all, plenty of 
regular exercise in the open air, preferably walking. 
Whole grain food, which stimulates the intestinal tract, 
and plenty of vegetables and fruit aid in preventing 
constipation. Oatmeal is very valuable in this way. 

A glass of cold water before breakfast or a glass of 
hot water at bedtime and many other simple and ef- 
fective means of encouraging the action of the bowels 
are in general use. They must not be accepted, how- 
ever, as substitutes for the dietary measures just re- 
ferred to. 

If constipation persists there is some reason for it 



PERSONAL HYGIENE 173 

and a physician should be consulted. If the services 
of a physician are not available, some harmless agent 
may be employed for temporary purposes. Probably 
the best of these is castor oil; licorice powder or one 
of the saline laxatives may also be used. On the other 
hand, nothing is more pernicious than the continued 
use of cathartics, and the temptation in this direction is 
very great, for they are advertised everywhere. These 
drugs not only do not relieve the constipation, but as 
a rule aggravate it. 

One thing in connection with this subject should be 
particularly borne in mind, and that is the importance 
of not only responding promptly to the calls of nature 
but establishing a regular time for this purpose, prefer- 
ably in the morning. Attention to this goes far to pre- 
vent constipation. 

VACATIONS 

Everyone, no matter what his station of life, should 
have at least a short period of relaxation or change 
of environment during the year. This is really an 
important economic consideration, for with this aid a 
person can not only recuperate in health but render 
better service in his work. 

Abroad, the public has learned through the experi- 
ence of centuries the value of providing, particularly 
for the poorer classes within municipal boundaries, at- 
tractive and pleasant means of relaxation. For a time 
at least, this takes them away from their troubles as 
well as unhealthy surroundings, particularly during 
the summer months. 

It is true, a vacation, particularly in the summer, is 



174 GOOD HEALTH 

a very important factor in preserving a good physical 
condition and mental equipoise. A large part of the 
population cannot enjoy this pleasure, but must depend 
upon some sort of day and night entertainment and 
relaxation which may be obtained at home. Unfor- 
tunately the great mass of people in this country do 
not select the recreation which is of most value to 
them. In this we are far behind European countries, 
for there they secure the most suitable and most val- 
uable means of rest and comfort at a minimum cost. 

Observing foreigners as well as others, who watch 
the struggling mass of humanity who daily visit our 
seaside resorts with little children, and are packed in 
crowded cars both coming and going, who, while 
at these resorts, are encouraged at every point to 
partake of improper food and drink, and who return 
home at night, tired, sunburned and irritable — all at a 
considerable outlay — cannot quite understand what ad- 
vantage is obtained from this form of so-called pleas- 
ure. Little benefit is derived from the sea air in a day's 
excursion, particularly when the weather is hot and 
there is constant exposure to the rays of the sun. The 
quieter inland places should be selected for a day's out- 
ing. There are many such places where shade and 
comfortable temperature may be found as well as an 
abundant supply of good drinking water, the last 
being a very important consideration. A luncheon 
taken from home offers more gratification than the 
food and drink purchased at the summer resorts, and 
the environment last described promises a much better 
opportunity for rest and recuperation. 



PERSONAL HYGIENE 175 

Neither the warm nor the cold term should be re- 
garded as an evil, but should rather be recognized as 
making up the normal climatic conditions of the chang- 
ing year. We shall not suffer unduly if we keep our- 
selves in a healthful condition by obedience to simple 
rules and an intelligent preparation for the weather 
and temperature which characterize our seasons. 

Hot and cold weather, like disease, usually select for 
their victims those who are in poor health or who 
are careless of their physical condition. Those who 
have good resisting power are but little affected by 
climatic change^. 



CHAPTER X 

HYGIENE OF THE HOME, SCHOOL AND WORKSHOP 

HYGIENE OF THE HOME 

While proper care of the body is necessary in 
maintaining a healthful condition, there are other very 
important contributory factors. Of these the most 
effective are cleanliness of environment and the early 
detection and proper care of infectious diseases. 

There is no hygienic measure so productive of good 
results as cleanliness. Lack of this renders the in- 
terior of the house offensive and unhealthful, and di- 
rectly or indirectly leads to other insanitary condi- 
tions. The observance of it, chiefly through the free 
use of soap and water, and not deodorants or disin- 
fectants, must be depended upon to keep the house 
wholesome. Disinfectants are called for only in the 
presence of infectious diseases; then they should be 
selected by and used under the direction of the family 
physician. 

In the construction of dwelling houses, every rea- 
sonable provision should be made to render cleaning 
easy. If the means of the household are limited, 
money intended for carpets should be spent rather for 
well built and closely laid floors which can be easily 
cleaned. They are also better and more sanitary in 

176 



HOME, SCHOOL AND WORKSHOP 177 

other ways. Good serviceable rugs add very much to 
the appearance of the floor and are not objectionable, 
but carpets are insanitary, for they rapidly accumulate 
dirt and are lodging places for organic matter, the 
unpleasant odors of which cannot be removed unless 
the carpet is taken up and renovated. 

Furniture makers of the present day have contrib- 
uted much to the proper and sanitary equipment of 
the house by making plain and light, as well as com- 
fortable, articles of furniture, which are easier to 
clean than those of older styles. This principle, as far 
as practicable, should be carried out in the dressing 
of the various rooms throughout the house. It is not 
intended that pleasing ornamentation should be dis- 
couraged, but the importance of cleanliness is not to 
be overlooked. 

In recent years, a method of indoor cleaning has 
been devised which accomplishes the removal of dirt 
and dust and is of great practical and sanitary value, 
and bids fair to become the ideal means of doing this 
work. It is not only effective in action, but prevents 
the distribution of dust about the apartment which al- 
ways occurs when the ordinary methods of sweeping 
are employed. This is known as the 'Vacuum proc- 
ess,'' and acts by a powerful suction force. Portable, 
efficient and comparatively cheap apparatus may be 
purchased as low as six or seven dollars ; their use is 
strongly recommended. If a broom must be used, a 
piece of wet cloth should be wrapped about the bot- 
tom to prevent dust flying about. It must be remem- 
bered, however, that neither the vacuum process nor 



178 GOOD HEALTH 

ordinary sweeping removes the tenacious, greasy mat- 
ter attached to woodwork. Soap and water cannot be 
dispensed with in any plan of house cleaning. 

There are at least two rooms in the house which 
call for special attention as regards cleanliness : these 
are the kitchen and the apartment where foodstufif is 
stored. Many housewives believe that soap and wa- 
ter are not adequate to keep rooms in good sanitary 
condition, and are persuaded to substitute all sorts of 
disinfectants and deodorants. Such agents are not 
necessary for cleaning purposes, for filth and dirt 
should be removed and not treated. The most effec- 
tive means of accomplishing this is by the free use of 
soap and water, which always secures the desired re- 
sult if properly employed. A solution of one pound 
of washing soda in three gallons of hot water is also 
valuable for this purpose. 

The woodwork in and about the kitchen and store- 
room and the various receptacles for food and waste 
products should be frequently and thoroughly scrubbed 
and cleaned to prevent the accumulation of decompos- 
ing organic matter which is responsible for the un- 
pleasant odor so frequently noticed in these places. 

The view from the back door of the kitchen in a 
country home is not always inviting, for it sometimes 
discloses the presence of a large amount of refuse 
matter. This is not only unpleasant but it furnishes a 
favorite breeding place for insects, some of which may 
act as media of infection. 

The most scrupulous attention should be paid to the 
icebox. Among the food products it contains there 



HOME, SCHOOL AND WORKSHOP 179 

are articles which decompose and become offensive 
even after all the contents are removed. For this 
special purpose, brushes of all kinds and shapes may 
be purchased for a small price, and inexpensive soaps 
and simple cleaning powders, which *'cut" and remove 
the greasy matter, can be purchased everywhere. 

At the present day, so many types of iceboxes 
are offered for sale that there is no difficulty in select- 
ing one which is satisfactory in make, size and price. 
An icebox should be so constructed that it is a non- 
conductor of heat, in order that the high temperature 
outside will not be transmitted to the articles con- 
tained in this receptacle. Furthermore, the icebox 
should be lined with porcelain or some glazed material 
which can be properly and thoroughly cleaned. 

An unclean kitchen, storeroom or icebox reflects 
unpleasantly upon those in charge, for the means for 
preventing this condition are within the reach of all, 
rich and poor. 

Boiling water may be depended upon to destroy all 
germs. The various table utensils may be freed from 
contamination by this means, provided they are placed 
in water and constantly boiled for at least five minutes. 
It is also important that the cellar should be kept 
carefully cleaned and the walls and floors properly 
cemented. If the latter are not impermeable, offensive 
fluids and gases may enter from the surrounding soil 
and contaminate foodstuff, particularly milk. An oc- 
casional coat of whitewash provides a simple means 
of keeping a well constructed cellar free from un- 
pleasant odors. 



i8o GOOD HEALTH 

Sinks and receptacles used for slops and other 
waste matter throughout the house should be planned 
for most painstakingly to insure cleanliness. About 
the premises, particularly in the country, there are 
cesspools and drains to deal with, which are often 
more or less offensive, and not infrequently there are 
dead animals and collections of decomposing matter 
which for the moment cannot be buried, removed or 
burned. Under these conditions, the use of deodo- 
rants is called for. The combination of sulphate of 
copper and lime and water mentioned in the chapter 
on deodorants is of value for this purpose. 

The great importance of promptly detecting the 
presence of infectious diseases will be referred to in 
another chapter. It is not expected that the members 
of a family will be competent to diagnose a case of 
sickness which may occur in the household, and so 
it is their duty to obtain promptly medical advice in 
order that the media of infection may be detected and 
the proper course taken to prevent the spread of dis- 
ease, principally through the careful isolation of the 
patient. 

The urgent need of proper toilet facilities is often 
unfortunately overlooked. In the country it generally 
consists of an outdoor privy vault, often in full view 
of the passerby. In this situation inclement weather 
and the discomfort of a night visit or other circum- 
stances often deter persons from promptly answering 
the call of nature, which is not without injury to 
health. At present there is little excuse for this con- 
dition of affairs, for modern equipment for the dis- 



HOME, SCHOOL AND WORKSHOP i8i 

posal of waste may now be installed at a compara- 
tively low price. 

To secure comfort as well as protection against in- 
fection, flies, mosquitoes and other insects should be 
excluded from the home. The most practical method 
of doing this is by the use of properly constructed 
wire screens which prevent the entrance of these in- 
sects into the house, rather than by fly ''swatters." 

HYGIENE OF THE SCHOOL 

Much has been written regarding the construction, 
ventilation, heating and lighting of schoolhouses, and 
the proper means of equipping them. While these are 
very necessary details, their consideration should not 
obscure the great importance of a daily visual inspec- 
tion of children at school for the purpose of promptly 
detecting any deviation from health, particularly the 
presence of infectious diseases. 

If children are in poor health they should not be al- 
lowed to study or remain in school. The responsibility 
of this rests largely upon the teacher. A daily visual 
examination of children, whether it is in the public city 
school or the district schoolhouse in the country, is 
neither impracticable nor difficult, nor is it necessary 
that this' procedure should annoy or interfere with the 
comfort of children during their hours of study, reci- 
tation and recreation; for they need not be especially 
informed that this method of daily observation is be- 
ing carried out. 

The preservation of a child's health depends largely 
upon care and observation on the part of his teacher. 



I82 GOOD HEALTH 

as a large percentage of children spend most of the 
day in school and at play, and not under the obser- 
vation of their parents. Therefore it is very essen- 
tial that teachers should be familiar with conditions 
which indicate a deviation from health, and also have 
an elementary knowledge of the early signs and symp- 
toms of the various infectious diseases which com- 
monly affect children. 

Not only should a daily visual examination be made 
for the detection of infectious diseases, but teachers 
should observe the children under their care to detect 
defective eyesight, imperfect hearing, the presence of 
adenoids, diseased tonsils and defective and decayed 
teeth. Much can be done to relieve these conditions 
if they are promptly recognized and quickly dealt 
with, and little help can be extended if they are al- 
lowed to go too long without proper care. Teachers 
should also carefully observe if children are improp- 
erly clad and if there is evidence that they are in- 
sufficiently nourished. 

It was formerly believed that the increased number 
of cases of infectious diseases among children at the 
beginning of the school year was largely due to the 
transmission of infectious matter by their clothing 
from homes where disease exists. This is not the true 
explanation, for diseases are transmitted in this way 
only in rare instances. Indisputable evidence has been 
presented proving that cases of infectious diseases are 
conveyed by mild and unrecognized cases and by '*car- 
riers." These are commonly found in schools, and 
constitute active media of infection. 



HOME, SCHOOL AND WORKSHOP 183 

Very successful results have followed the work of 
"school corps/' whose function consists in the fre- 
quent examination of school children to detect the 
presence of infectious disease or conditions which may 
unfit them for study. Unfortunately, school corps 
are available only in large cities, so that the visual ex- 
amination of school children in smaller places, particu- 
larly in the country, must be placed in the hands of 
the teachers, but always under the general direction 
of some medical officer. 

If a child is apparently in poor health or presents 
symptoms suspicious of infectious disease, he should 
be quietly sent home with a communication to the par- 
ents requesting that a prompt examination be made by 
a physician, and a report forwarded as to the diagno- 
sis of the case. This is necessary for the protection 
of schoolmates as well as the affected child. 

A cold in the head with suffused or congested eyes 
are symptoms which usher in measles, and a sore 
throat may be the forerunner of diphtheria or scarlet 
fever, while a few spots just appearing on the skin 
may be the onset of smallpox or some other eruptive 
disease. When such evidence of ill health or disease 
is presented, teachers should lose no time by suggest- 
ing remedies or various modes of treatment, for they 
are not qualified to do this, but in the interest of all 
concerned they should endeavor as promptly as pos- 
sible to place the child in the hands of the family phy- 
sician. 

Teachers should carefully observe the manner in 
which children study and they must not assume that 



.184 GOOD HEALTH 

they are relieved from this obligation because modern 
seats or other equipment has been installed; neither 
should they overlook the need of a daily observation 
as to ventilation, heating and lighting because others 
may be directly responsible for this condition. 

The proper ventilation of a schoolhouse cannot be 
determined by measurements or by a theoretical esti- 
mate of the number of cubic feet of air required for 
each person, although a knowledge of this is neces- 
sary in order that there may be a scientific standard to 
work upon. Those in charge of the ventilation of 
schoolhouses away from great centers will perform 
their part if they have learned the great need of fresh 
air and the simplest means by which it may be ob- 
tained. 

In the construction of new school buildings, the 
question of ventilation, heating, lighting and sanitary 
arrangement may properly be left to the architect. It 
is where old structures are used as schoolhouses, par- 
ticularly in the country, that special effort is required 
on the part of those in charge of educational matters, 
to render these buildings good enough for school pur- 
poses. 

It is also in the country that the most primitive 
and inadequate toilet accommodations are found, yet 
it is this which should receive the most careful atten- 
tion. There should be a separate and distinct apart- 
ment for each sex, and the construction of these places 
should, as far as the circumstances permit, conform 
to modern sanitary requirements. Special care in this 
direction is one of the most effective means of educat- 



HOME, SCHOOL AND WORKSHOP 185 

ing children as to the importance of proper hygienic 
measures. 

There is no place where personal cleanliness is more 
urgently demanded or where its importance can be 
more conveniently and effectively taught than in the 
schoolhouse. Contrary to the general belief, disinfec- 
tants are not required in schools, but the need of soap 
and water is always present. It is not true that germs 
are everywhere in the schoolroom in their active state 
ready to transmit infection. 

Children commonly contract measles, diphtheria and 
scarlet fever by contact with those who have these 
diseases, commonly in a mild and unrecognized form, 
the infectious matter being contained in the discharges 
from the nose, throat and ears. Infectious matter is 
conveyed not only by direct contact but by articles 
which are contaminated with the discharges, such as 
common drinking cups and towels. Therefore, these 
should be replaced by individual drinking cups, or 
drinking water should be supplied by an apparatus 
which does not permit of contamination. Paper towels 
should be supplied instead of common roller and other 
towels. Furthermore, the exchange of partly eaten 
food or fruit, chewing-gum and other articles which 
are transferred from the mouth of one to another 
should be prevented. 

Hygiene should form a part of a child's earliest in- 
struction. There is no age at which these little ones 
cannot absorb some knowledge of the principles which 
govern this important subject. It instils into their 
minds the value of at least some of the hygienic meas- 



i86 GOOD HEALTH 

ures, particularly cleanliness, and has a more lasting 
effect than when this education comes later in life. 
Unfortunately, too little attention is given to the mat- 
ter either in private or public schools. 

It is not difficult to appreciate the great responsibil- 
ity which rests upon school teachers, particularly those 
in country places, where they have but few aids in 
carrying out the work of education. The fact is that 
they are largely responsible, not only for the book 
knowledge of children and for their manners, but also 
for the preservation of their health. Some mothers, 
particularly those among the working classes, devote 
but little time to the care and education of their off- 
spring and are only too willing to shift the responsibil- 
ity to the shoulders of teachers, whose valuable serv- 
ices are not fully appreciated and whose remuneration 
is far below what it should be, particularly in the 
country. 

HYGIENE OF THE WORKSHOP 

The term ^'workshop," in its broadest sense, refers 
to buildings or apartments where persons are engaged 
in the commercial and industrial pursuits. It more 
commonly applies to factories where many employees 
are brought together in the performance of their 
work. Hygiene of the workshop relates to the sani- 
tary arrangement of the interior, the means taken by 
the employers to guard against infectious diseases and 
the personal cleanliness of those present. 

The offensive odors noticeable in a workroom often 
come from unclean skin and clothing and decayed 
teeth of those present, as well as the various articles 



HOME, SCHOOL AND WORKSHOP 187 

used in the manufacture of goods. It will thus be seen 
that employers are not entirely responsible for insani- 
tary workrooms, for the condition of these places de- 
pends largely upon the personal habits of the em- 
ployees. 

An employer who provides a sanitary workshop, 
which is spacious, attractive and well lighted, not only 
renders valuable aid in preserving the health of his 
employees, but goes far to teach them the importance 
of personal hygiene. Furthermore, proper care of 
employees is of substantial economic value to the em- 
ployer, for it aids in maintaining health and energy, 
and yields far more satisfactory and less interrupted 
service. 

A lavatory properly equipped with modern sani- 
tary fixtures, plenty of wash basins, a good supply 
of soap and towels and a sufficient number of prop- 
erly constructed waterclosets is also a very effective 
means of impressing employees with the need of per- 
sonal cleanliness. As it has already been stated, in- 
sufficient toilet accommodations interfere very serious- 
ly with the calls of nature, and this irregularity, when 
persisted in, is detrimental to health. 

Any towel which is used in common is a very filthy 
and insanitary article and is unfit for use at any time. 
Diseases may be transmitted by a common towel, for 
infectious material is conveyed from one person to an- 
other through the medium of discharges, which easily 
contaminate the towel. While individual linen towels 
go far to prevent the danger referred to, they are 
not infrequently lent to other persons and are not al- 



i88 GOOD HEALTH 

ways sent to the laundry as often as they should be. 
The risk is not present when paper towels are em- 
ployed, for they cannot be used more than once. With 
paper towels there is no expense for washing or for 
the loss and destruction of towels — not a small item 
where a large number is used. It is true the cost of 
laundering, etc., may be equaled by the cost of paper 
towels, yet the fact remains that the advantage, as far 
as cleanliness and the prevention of disease is con- 
cerned, rests with the latter. 

While paper towels do not perform all the functions 
of an ordinary towel, they are sufficient for the work- 
shop or office, where only the hands and face, particu- 
larly the former, need immediate attention. Paper 
towels may be purchased at a very low price, from 
six to ten for a cent, depending upon the material 
and the number ordered. A good serviceable paper 
towel acts very much like a blotter. It should be care- 
fully pressed against the skin and left there for a 
moment to absorb the water, then gentle friction 
should be used with the dry part of the towel. 

Infectious diseases may also be transmitted from 
one person to another by common drinking cups. This 
may be prevented by the use of receptacles which 
remain in the possession of the owner, or still better, 
paper cups which are destroyed after use. Various 
forms of faucets which direct a stream of w^ater up- 
wards and which may be used without touching the 
apparatus with the mouth are also of practical value 
in the prevention of disease. 

In late years very inviting resting rooms have been 



HOME, SCHOOL AND WORKSHOP 189 

prepared for employees, and in many instances lunch- 
eon is provided in the building. While to a certain 
extent these are of value, they are not in full accord 
with the principles of modern health methods. Em- 
ployees whose duties are of sedentary nature often 
experience a sense of fatigue. This is a mental and 
not a physical condition and the logical remedy for 
it is exercise in the open air and not rest. If at the 
noon hour, clerks, typists, operators, etc., could be 
induced to walk or take some mild form of exercise 
in the open air for half an hour or so before luncheon, 
it would be far more valuable than rest, although at 
first it might not be appreciated. Moreover, rest rooms 
are quite apt to lead to slothful habits. 

Lunch rooms provided in workshops or offices are 
instituted not without some idea of profit to employ- 
ers ; for it is believed that by this means less time will 
be taken for the noon meal. The value of this ar- 
rangement lies chiefly in the fact that good food may 
be provided at a minimum cost. On the other hand, 
it offers no encouragement to employees to seek the 
benefits of outdoor air during the middle of the day, 
which is refreshing and productive of better service. 

From the standpoint of health, it would be far bet- 
ter if the employers who contemplate providing lunch- 
eons for their employees, either free or at a minimum 
cost, would locate the lunch room some distance from 
the shop or office, thus requiring open air exercise by 
the employees who wish to secure the benefits of this 
arrangement. 

While the roof of a building may be used for an 



190 GOOD HEALTH 

airing and for certain forms of exercise, it is of re- 
stricted value, for only a small proportion of em- 
ployees can or will take advantage of this means of 
obtaining fresh air. Exercise in the form of walking 
is particularly beneficial at the noon hour, for it bet- 
ter prepares one for the remaining part of the day's 
work. 

Every employer should make special provision to 
guard his employees from infectious diseases. Great 
aid may be extended in this direction by a daily vis- 
ual examination of employees in order that the pres- 
ence of eruptions and other evidences of ill health may 
be promptly detected. If these exist, the persons af- 
fected should be directed to go home, seek medical ad- 
vice and promptly report the doctor's opinion in the 
case. This will enable the employer to take such ac- 
tion as may be necessary to protect employees who 
have been exposed. Many outbreaks of disease have 
been prevented in this way. A visual examination of 
the employee requires little time on the part of the em- 
ployer and need cause no annoyance to employees, who 
indeed need not even know that an examination of this 
kind is taking place. 

Modern sanitary engineers have gone far towards 
perfecting the construction, ventilation and lighting 
of new factories and apartments where many em- 
ployees are brought together, but there are buildings 
in use which are old and of imperfect construction. 
It is the latter class which calls for the most careful 
attention in securing at least reasonably good sanitary 
conditions. 



HOME, SCHOOL AND WORKSHOP 191 

During the warm weather, electric fans properly 
placed in the working rooms and so arranged that they 
are not unpleasantly active or cause too rapid evapora- 
tion from the skin, contribute much to the comfort of 
the workers. 

The ventilation of a workshop also requires special 
consideration during the cold weather, for the win- 
dows and doors are usually kept closed and the apart- 
ments are usually overheated. This not only inter- 
feres with ventilation, but renders employees more 
susceptible to colds and other affections, particularly 
if manual labor is being performed. This subject 
has already been dealt with in the chapter on Ven- 
tilation. The general principles of ventilation hold 
true whether in the home or in the workshop. 



CHAPTER XI 

BACTERIA^ INFECTIOUS DISEASES AND THE MEANS BY 
WHICH THEY ARE TRANSMITTED 

BACTERIA 

Such a wealth of information is available concern- 
ing bacteria and their relation to disease, that it is 
only proper the public should have a general knowl- 
edge of the subject in order that more advanced 
methods may be followed in the preservation of health. 

As early as the seventeenth century, various inves- 
tigators had observed, with the aid of the weak and im- 
perfect magnifying glasses of that period, that solids 
and fluids contained very small living bodies which 
were seen to move about in the field of vision. As the 
power of these glasses became increased through more 
skillful grinding, still smaller objects were revealed, 
until the microscopes of today are able to detect the 
most minute organisms, some of which, not more than 
1/50,000 of an inch in size, are brought clearly into 
view and easily studied. These little bodies, or mi- 
croorganisms, are known by the common and familiar 
name of bacteria or germs. 

Although some of the larger of these bodies were 
early recognized, they remained for a long time chiefly 
objects of curiosity until their real significance was ap- 

192 



INFECTION 193 

predated and they were carefully studied and classi- 
fied. Within the past quarter of a century rapid strides 
have been made in this direction. Bacteriology, which 
treats of this subject, plays an exceedingly important 
part in the prevention and cure of disease. 

Even long ago, it was suggested that these rninute 
living bodies were in some way connected with the 
transmission of infection from one person to another, 
although comparatively little definite published knowl- 
edge was obtained on the subject until about 1880, 
when Pasteur and Koch, respectively French and Ger- 
man bacteriologists, working independently of each 
other, presented to the world conclusive evidence of 
the germ origin of disease. Since that period, labora- 
tories throughout the world have been engaged in the 
most important and exhaustive investigations in this 
field. 

Bacteria are arranged in groups or classes, and the 
characteristics of each individual organism are care- 
fully studied as well as the conditions under which it 
thrives best and the agents which are destructive to it. 

Bacteria, or germs, are divided according to their 
shape into three groups. Those which are round are 
known as cocci; those which are long or rod-shaped as 
bacilli; and the curved or spiral ones are called spirilla. 
These groups do not change from one shape to an- 
other, although the individuals of the different groups 
have certain peculiarities by which they may be distin- 
guished from others of the same group. Bacteriolo- 
gists must be familiar with these conditions in order 
to recognize the various germs which cause disease. 



194 GOOD HEALTH 

For instance, the round bacteria, or cocci, are found 
in pneumonia and meningitis; the long or rod-shaped 
bacteria, or bacilli, are present in typhoid fever and tu- 
berculosis ; and the curved or twisted bacteria, known 
as spirilla, appear in cholera. While it is often difificult 
to separate and identify the various germs of each 
group, continued increase in the power of the micro- 
scope and more effective means of staining the germs, in 
order that they may be more easily detected, and the 
specific serum tests have accomplished much in remov- 
ing difficulties connected with this work. This is ex- 
ceedingly important, for the identification of many dis- 
eases now depends almost entirely upon bacteriological 
examination. It is believed that largely through aid 
obtained in this way some of the infectious diseases 
will be eliminated. 

Very valuable information has been acquired re- 
garding what takes place after the germs enter the 
body, particularly as to the manner in which they 
cause diseases and what becomes of them. When we 
consider the organisms which may gain entrance into 
the system and the rapidity with which they multiply, 
in some instances doubling in number about every 
twenty minutes, it is hard to understand how we es- 
cape serious results after infection has once taken 
place. 

In recent years definite knowledge relating to this 
part of the subject has been secured, and quite clearly 
shows the manner in which the body protects itself 
against this danger. While this is not by any means al- 
ways sufficient to prevent a fatal result in the various 



INFECTION • 195 

forms of infection which attack the human body, the 
fact that recovery so commonly ensues is due largely 
to this means of protection. 

In the blood are found microscopic bodies known as 
leukocytes, or white blood corpuscles, the function 
of which for a long time was in doubt. Now it is 
known that in addition to whatever else they may do, 
they are germ destroyers ; and under the microscope, 
the leukocytes may be seen drawing the germs within 
themselves for destruction. After a while the body re- 
acts to the germs and the blood acquires a germicidal 
power. 

It is not the mere presence of bacteria within the body 
which is responsible for the danger which may follow 
an invasion of this kind, but more directly the fact that 
these organisms give off a poisonous product known as 
toxin. The presence of this poison in the body stimu- 
lates and causes the blood to produce a protective agent 
or antagonist, known as antitoxin, also antibodies, to 
neutralize the toxin. Therefore both the blood and the 
leukocytes which it contains are powerful agents of de- 
fense against the bacteria and their poison. 

It was the belief of bacteriologists who early studied 
this subject that if antitoxin or germicidal serum could 
be prepared in large quantities outside the human 
body, and promptly introduced into the system when 
infection occurs to aid the antitoxin already formed in 
the blood of the person affected, it would go far to 
render the disease mild ; or if injected into the body of 
those who have been exposed, it would probably ren- 
der them immune or prevent the appearance of the 



196 GOOD HEALTH 

disease. In the investigation of this subject it was 
found that some animals, particularly the horse, pro- 
duce large quantities of antibodies and are not suscep- 
tible to the action of infectious germs, which are dan- 
gerous to human beings. 

This formed the basis of a most exhaustive series 
of experiments which demonstrated the fact that if 
germs of certain diseases, or rather the poison they 
generate (toxins), is injected into the circulation of 
the horse it is followed by the production of antitoxin 
or germicidal substance in large quantities. In order 
to obtain this for use in the human being the blood is 
withdrawn from the horse by opening a vein and the 
fluid portion or serum which contains the antitoxin or 
antibodies is afterwards separated, or decanted. This 
product is then bottled and sealed and ready for dis- 
tribution, great care being taken to prevent outside 
contamination. The use of this is known as the anti- 
toxin treatment. 

As each form of bacteria produces its own peculiar 
poison, it naturally follows that a special antitoxin is 
necessary for each disease. For instance, to secure a 
diphtheria antitoxin, horses are injected with the diph- 
theria toxin. 

The diphtheria antitoxin has probably proved the 
most successful of all in connection with this form of 
treatment, and its use is indicated not only in cases of 
this disease, but also as a preventive measure. Teta- 
nus, or lockjaw, antitoxin has also proven extremely 
valuable in the prevention of lockjaw. Other protec- 
tive sera have been prepared and are in use. 



INFECTION 197 

Serum and vaccine treatment differ in this way. In 
the serum method the fluid portion of the blood of an 
immunized horse, already referred to, is injected into 
the human body, while the vaccine treatment consists 
either in injecting under the skin or rubbing into its 
scarified surface dead or living organisms of certain 
diseases. If the living organisms are used, they are 
first rendered unable to do any active danger them- 
selves, and in either instance, it is the poison given 
off from the germs which is expected to stimulate 
the cells of the body to furnish antibodies that will 
give immunity against the disease in question. While 
these forms of treatment affect the system, sometimes 
very actively, the effect is transient and comparatively 
trivial compared with the effects of the disease which 
the vaccine is given to prevent. 

Vaccination for the prevention of smallpox is a very 
peculiar example of one form of treatment. In this 
method the arm or leg is scarified and the vaccine mat- 
ter rubbed into the skin to be quickly absorbed. In 
antityphoid vaccination the organisms are injected un- 
der the skin. 

Bacteriologists have found that under some condi- 
tions vaccines work more effectively as immunizing 
agents than sera, and vice versa. Therefore both are 
employed. The final word has not been said regarding 
their degree of efficiency nor the unpleasant results 
which may follow this treatment if not committed to 
the hands of those skilled in its use. 

It is important that the public should know some- 
thing of the antitoxin and vaccine treatment, but it 



198 GOOD HEALTH ' 

should be warned against the employment of these 
agents by unscrupulous and incompetent persons who 
often suggest this form of treatment in order to make 
use of worthless and dangerous products. This is par- 
ticularly true in connection with tuberculosis. There is 
no germicidal serum, antitoxin or vaccine yet produced 
which is of very real practical value in the treatment of 
tuberculosis, and any agent advertised for this pur- 
pose should be carefully avoided. Besides, no form of 
antitoxin treatment should be allowed except upon the 
recommendation of some reputable physician who is 
competent to decide when this remedy is indicated and 
where a proper supply can be obtained. 

While the value of the means of defense above re- 
ferred to cannot be overestimated, there is a more im- 
portant factor in guarding against the danger of in- 
fectious disease, and that is good health. Conclusive 
evidence has been presented that not only are bacteria 
upon entering the system far more dangerous when 
the resisting power of the body is low, but at such 
times the antitoxin-forming function of the blood is far 
less effective. Therefore, preparation to meet the dan- 
ger is largely in our own hands, for by carefully con- 
forming to the rules of personal hygiene, we may go 
far to avert the attacks of infectious diseases. 

The above account of bacteria applies chiefly to 
pathogenic organisms, that is, germs which produce 
infectious diseases, but the far greater number of bac- 
teria — and it is those with which we are in more or less 
constant contact — are not of this order. They are as a 
rule harmless, or in some instances very necessary to 



INFECTION 199 

our well being and aid in our protection. For instance, 
some of them are exceedingly active in the destruction 
of dead and putrefying material. 

These forms of bacteria may be found on our body, 
clothing, money and wherever there is exposure. They 
do not transmit disease, although the public are made 
apprehensive regarding their presence. It is sufficient 
to know that they are not the menace they are believed 
to be. This form of bacteria will again be referred to 
in the following section. 

INFECTIOUS DISEASES AND THE MEANS BY 
WHICH THEY ARE TRANSMITTED 

No subject touching upon the protection of health 
has received more exhaustive investigation than that 
relating to the means by which infectious diseases are 
transmitted from one person to another. Certain the- 
ories connected with this subject, which have been long 
and universally accepted, are now known to be largely 
erroneous. The most notable of these is the so-called 
'*fomites" theory, which holds that clothing, baggage, 
cargoes of vessels, various textile fabrics, money, etc., 
transmit pathogenic or disease-producing organisms 
from one person to another. The truth is that these 
articles are not media of infection except in rare in- 
stances. 

While the fomites theory has until recent years been 
generally accepted, there is little scientific evidence to 
sustain it, and its chief support lies in the fact that it 
ofifers a plausible explanation for outbreaks of infec- 
tious disease, the origin of which is unknown or at 



200 GOOD HEALTH 

the time cannot be explained. The presence of this 
belief inspires the fear that sources of infection exist 
almost everywhere. 

The supposed danger according to the fomites theory 
is responsible for many unnecessary and ridiculous 
practices. For instance, a person will grasp a car strap 
very cautiously for fear of contracting disease, and yet 
he will handle without a qualm the handrail of a pub- 
lic stairway and various other exposed surfaces which 
may be contaminated with the same forms of bac- 
teria. It is true that these exposed surfaces harbor 
many germs, but as a rule they are harmless and exist 
everywhere, and will be found on our hands, the linen 
we wear, etc. While it is possible that in some in- 
stances pathogenic organisms are present, the danger 
of their transmitting disease is very remote and need 
cause no apprehension. For when these organisms are 
deposited upon clothing or other articles they probably 
become inactive from exposure ; besides, they are sep- 
arated from the substance which provides them with 
nourishment. Frequent cleansing of the hands will go 
far to prevent any possible infection from this direc- 
tion. 

Old and filthy money is popularly looked upon as a 
fruitful source of infection. There is really nothing to 
substantiate this belief. While it is desirable that old 
paper money be removed from circulation and new 
bills substituted, it should be understood that it is for 
appearance's sake and not because of danger of in- 
fection. 

It is still believed by many that infection is trans- 



INFECTION 201 

mitted over long distances through the air, even a mile 
or more (aerial infection). There is not only no sci- 
entific authority for this, but the proposition that dis- 
eases are transmitted in this way, except in the imme- 
diate vicinity of the source of infection, is not entitled 
to respectful consideration. There are many other 
popular notions of this kind which have long been cher- 
ished, but in recent years these have also been proved 
to be without support. 

What, then, are the true means of infection? For- 
tunately, we now have very extended and definite in- 
formation on the subject. Infectious diseases are 
usually transmitted ( i ) directly from one person to an- 
other through the medium of discharges from the body 
which contain infectious germs or organisms in their 
active state; (2) indirectly through the medium of 
contaminated food and drink, and (3) by certain biting 
insects, mosquitoes, for example, which in the manner 
of their kind, transmit infectious agents from one per- 
son to another. 

If all cases of infectious diseases were well marked 
and could be promptly and easily identified, the danger 
of their spread would be greatly diminished, for we 
could then better guard against infective discharges; 
but unfortunately, these diseases very often appear in a 
mild, irregular and unrecognized form, and are over- 
looked or mistaken for some simple malady and usually 
treated with home remedies. 

Another very common and dangerous source of in- 
fection, and one which is now becoming more fully 
recognized, is what are known as ''carriers/' that is, 



202 GOOD HEALTH 

persons who retain actively infectious organisms within 
their body and who themselves are apparently well, yet 
through the medium of infectious discharges may 
transmit disease to others. This very frequently occurs 
in connection with typhoid fever. 

Certain insects transmit infection. We have indis- 
putable evidence that malarial and yellow fever are 
conveyed from one person to another by the bite of 
certain infected mosquitoes, and as far as we know at 
the present time, there are no other means by which 
these diseases are communicated. The fly is also re- 
garded as a medium of infection. The flea that infests 
the rat transmits the infection of bubonic plague, and 
it has recently been shown that the body louse proba- 
bly carries the germ of typhus fever from one person 
to another. 

Filth does not cause infectious diseases, but disease 
thrives best where there is filth, overcrowding and bad 
air. To illustrate : During the outbreak of typhus 
fever which occurred in New York in the winter of 
1893-4, over seven hundred cases were discovered, and 
all but two or three of them were found among the ten- 
ement and lodging house population where uncleanli- 
ness, lice and overcrowding were rife. 

The prompt detection of an infectious disease is 
vitally important, for this not only offers better chance 
for recovery for those who are ill, but goes far to pre- 
vent the spread of infection. Unfortunately, tubercu- 
losis, which exists almost everywhere, frequently 
reaches an advanced stage before its character is 
known, and little can be done for the patient; mean- 



INFECTION 203 

while infective matter has been slowly distributed. 
Smallpox often appears in a mild form, and not un- 
frequently is mistaken for a condition which is not in- 
fectious. Through such errors, serious outbreaks may 
follow. 

Diphtheria, measles and scarlet fever, which are 
more or less constantly present, are frequently unrec- 
ognized. There is no doubt that the increased number 
of cases which occur at the beginning of the school 
year is due largely to the transmission of discharges 
from mild and undetected cases, and not from infected 
clothing, as was formerly supposed. 

In tuberculosis it is the sputum or expectoration 
which contains the infectious organisms. Through 
sprays or droplets thrown off from the respiratory 
tract and in other ways, largely through uncleanliness, 
the organisms are transmitted from one person to an- 
other, the more readily where insanitary conditions ex- 
ist, for then less care is taken to guard against the 
danger. 



CHAPTER XII 

MOSQUITOES AND FLIES AND THEIR EXTERMINATION 

The extermination of mosquitoes is a very impor- 
tant factor in the preservation of health, not only be- 
cause they constitute a source of annoyance, but far 
more serious, because they transmit infectious germs 
from one person to another. Their elimination cannot 
be successfully accomplished unless there is proper 
widespread cooperation between the public and mu- 
nicipal and state authorities. For this reason it is nec- 
essary that we should know something of the habits of 
these insects and the manner in which they live and 
breed. 

During the early part of the last century it was sug- 
gested that in some way insects might act as a media 
of infection. However, the limited resources of bac- 
teriology at this time, as well as other conditions, dis- 
couraged the thorough investigation of this subject. 
Little was done in this direction until 1880, when Dr. 
Laveran, a French army surgeon on duty in Algiers, 
found in the blood of malarial cases under his care a 
germ or organism which he believed to be the cause of 
this disease. He announced his discovery to the Paris 
Academy of Medicine and his statements were after- 
ward confirmed by other investigators. 

204 



MOSQUITOES AND FLIES 



205 



Then the question arose as to the means by which 
these organisms are introduced into the human body. 




Fig. 19. — The mosquito: female. While the antennae of the female 
have hairlike processes (see above), the antennae of the male 
consist of well marked and easily recognized plumes. 



This led to extended research which after some time 
resulted in the discovery that the infectious organisms 
of malaria are transmitted from one person to another 
by a variety of mosquitoes known as the "Anopheles/' 



2o6 GOOD HEALTH 

So far as we know at present there is no other way by 
which this disease can be communicated. 

Following this important discovery, further evidence 
concerning the danger of the mosquito as a medium of 
infection was presented. This occurred during the oc- 
cupation of Cuba by the United States Government 
in 1900. At that time a commission composed of 
medical officers of the Army was appointed by the 
President for the purpose of identifying, if possible, 
the germ of yellow fever, and the means by which it 
was transmitted. While the germ of this disease has 
not been found, the Commission was able to present 
indisputable evidence that whatever it may be it is 
transmitted from one person to another by the mos- 
quito; and as in the case of malaria it is believed that 
there is no other medium of infection. The variety of 
the mosquito which transmits yellow fever is known 
as the ''Aedes" or ''Stegomyia." 

It has been proved, therefore, that the infectious 
organisms of two diseases which cause great suffering 
and loss of life throughout the world, are transmitted 
by mosquitoes. More recently it has been found that 
other diseases are also conveyed from one person to 
another by these insects. We are not yet aware to 
what extent infection may be conveyed in this manner. 
It is sufficient to know that mosquitoes constitute a 
dangerous menace to health. It may be added that 
the Anopheles and the Stegomyia transmit diseases 
only when they are carriers of the infectious organ- 
isms. At other times they are no more harmful than 
the more common or ordinary mosquitoes. 



MOSQUITOES AND FLIES 207 

Mosquitoes propagate only in water, upon the sur- 
face of which they deposit their eggs in large numbers, 
usually two or three hundred at a time. Within twen- 
ty-four hours afterward, hatching takes place and the 
larvae appear. These little bodies, which can live only 
in water, are commonly known as 'Svigglers,'' and 
when full grown are about a quarter of an inch long. 
At first they are so small that they are not usually de- 
tected by the naked eye except by those familiar with 





Fig. 20. — Manner in which the eggs of the Culex pipiens, or com- 
mon house mosquito, are deposited. (Howard.) 



their propagation; after two or three days they are 
easily recognized. 

A very simple and interesting way of studying the 
habits of the larvae consists in placing the water which 
contains them in a glass in front of a light. On look- 
ing through the glass the larvae will be seen moving 
about in the water in a rapid and jerky way. It is in- 
teresting to note that while the larvae cannot live out 
of the water they must have air; therefore, every min- 
ute or so their tails are projected above the surface, for 
this extremity contains the minute opening of the res- 
piratory apparatus. Thus it may be said that the 
larvae breathe through the tail. 

After a period of six or eight days, the head of the 



2o8 GOOD HEALTH 

larva becomes enormously enlarged, resembling a 
comma in appearance. This is known as the ''pupal" 
stage and lasts about two days, terminating in the birth 
of the winged insect. A pupa is inactive except when 
frightened, and lies close to the surface of the water, 
requiring little or no food. 




Fig. 21. — Eggs of the Anopheles. (Howard.) Those of the Steg- 
omyia and some other varieties of the inland mosquito and also 
the Culex sollicitans are laid similarly to these. 

If the observer has the time and patience to watch 
a pupa carefully for a day or so, it will be seen to rise 
to the surface of the water for the last time. Grad- 
ually the envelope or covering which surrounds it is 
broken and the full grown mosquito appears. It hesi- 
tates for a moment, resting on the envelope or shell to 
get its bearing, and then flies away. 



MOSQUITOES AND FLIES 



209 



While there are many varieties of mosquitoes, it 
will be sufficient to refer to the more common ones, 
particularly those which are found in this country. 
Two classes may be described : the inland mosquito 
and the Atlantic Coast mosquito, also known as the 




Fig. 22. — The mosquito larva. 



*^salt water swamp'' or ''striped-legged'' mosquito. 
The most common inland mosquito, the Culex pi- 
piens, which is found throughout the world, is fre- 
quently called the house or rain barrel mosquito, and it 
is the one usually found indoors. It is of medium size 
with a rather thin body, its color ranging from a deep 
yellow to a dark brown, with legs of practically the 
same shade. It has no marking on the back or feet. 
The Anopheles, or malarial, mosquito is a variety of 



210 



GOOD HEALTH 




Pig. 2$' — Position of larva of common mosquito in obtaining air. 

(Howard.) 

the inland mosquito. If carefully examined it will be 
found to have wings which are mottled or spotted with 
brown or black. When at rest its body is almost at 




Pig. 24. — Position of Anopheles larva in obtaining air. (Howard.) 



MOSQUITOES AND FLIES 211 

right angles with the surface upon which it rests, while 
the body of the Culex pipiens is parallel to it. 

The Aedes, or Stegomyia, or yellow-fever, mosquito 
is also a variety of the inland mosquito, and is found 
principally in the West Indies, South America, Mexico^ 
and the southern part of the United States. It has the 
reputation of being in appearance the most attractive 
of all mosquitoes. It is comparatively small, with bril- 



Fig. 25. — Pupa. (Smith.) 

liant yellowish stripes across its abdomen, thorax and 
legs. On the legs the stripes are not so pronounced 
as in the case of the ''striped-legged" or Atlantic Coast 
mosquito, and it has no transverse stripes on its beak — 
the reed-like process extending from the head — which 
is found in the latter variety. Both the Anopheles and 
the Stegomyia are house mosquitoes and usually re- 
main quite close to their breeding places. 

The Sollicitans, or Atlantic Coast, mosquito is not so 
often found within the house, but usually makes its at- 
tack outside. It is easily recognized with the naked 
eye by broad white or light-colored stripes on its legs 



212 GOOD HEALTH 

and one in the middle of the beak, the latter offering 
the most important means of identification. This mos- 
quito breeds in the salt marshes along the Atlantic 
Coast, and has also received the name of striped-legged 
or salt marsh mosquito. It propagates in such large 
numbers that some coast towns are almost uninhab- 
itable. 

It was formerly believed that all varieties of mos- 




Pig. 26. — Culex pipiens, or common house mosquito, female. 
(Howard.) 

quitoes breed wherever water can be found. Now we 
know that the inland mosquito does not breed in salt 
water swamps and that the striped-legged mosquito 
does not breed inland. This knowledge is of great 
practical value in the extermination of these insects. 

The breeding places of the inland varieties of mos- 
quitoes are so numerous that they often escape detec- 



MOSQUITOES AND FLIES 213 

tion even by those who are making careful search for 
them. For this reason the work of extermination is 
often difficult. Common breeding places are excava- 
tions, old tin, crockery and glassware, cesspools, drains, 
water troughs, rain barrels, cisterns, broken roof lead- 




FiG. 2^. — Anopheles, or malarial mosquito, female. (Howard.) 

ers, and the like. Mosquitoes also breed in urns in 
cemeteries, statuary in parks, excavations for new 
buildings, street sewers, water tanks, etc. 

Contrary to the general belief, mosquitoes do not 
breed in large bodies of water, except where it is par- 
ticularly rich in organic matter, in which cases they 



214 GOOD HEALTH 

breed along their edges in small pools. They prefer 
small collections of water containing rich vegetation 
where they are quiet and better protected. While 
some varieties of inland mosquitoes may be satisfied 
with clean water for breeding purposes, the more com- 
mon types choose that which is contaminated and 
filthy, as it contains more nourishment for the larvae 
in the shape of decomposed organic matter. There- 
fore, the additional danger of filthy and stagnant water 
is evident. 

As already stated, the Atlantic Coast mosquito breeds 
in salt or brackish water but not inland. Those who 
have not seen the great swamps along the Atlantic 
Coast can form no adequate idea of the enormous 
breeding places they supply in the shape of surface de- 
pressions, which are more or less constantly covered 
with water from the incoming tide. 

Mosquitoes live on plants, fruits, etc., although the 
females, the only ones which bite^ crave blood, as 
those living in mosquito infested districts will testify. 

The larvae are voracious eaters and move rapidly 
about in the water in quest of food. Probably little 
or no nourishment is required during the pupal stage, 
for, as above explained, this is preliminary to the ap- 
pearance of the winged insect. 

It is commonly believed that mosquitoes live only 
one day. There is no warrant for this belief, and al- 
though it is difficult to fix definitely their life cycle, it 
may be said that the females probably live about two 
or three weeks and the males a few days only. 

Perhaps no question concerning the habits of mos- 



MOSQUITOES AND FLIES 215 

quitoes has been more widely discussed than the dis- 
tance which they travel from their homes or breeding 
places. The inland mosquito is not voluntarily a mi- 
gratory insect, but usually remains near its breeding 




Fig. 28. — Stegomyia, or yellow fever mosquito, female. (Howard.) 

place unless driven away by winds, smoke, etc. This 
knowledge is of great practical value in the extermina- 
tion of this variety, for if it is found in large numbers 
at a given place it may be safely assumed that the 
breeding place is not far away. This must not be relied 
upon too implicitly, however, for inland mosquitoes 
may travel further than we believe. 

The Atlantic Coast, or striped-legged, mosquito is 



2i6 GOOD HEALTH 

notoriously a roaming insect, for it is commonly found 
miles from home. It is believed that these journeys 
are voluntary and in quest of food best suited for its 
use, which is apparently found only in salt water 
swamps. 

The sudden appearance of a large number of mos- 
quitoes suggests that they have been brought from a 
distance by winds, and if the direction of the wind is 
ascertained, some information may be obtained as to 
the location of breeding places. There is no doubt 
that mosquitoes are carried from one place to another, 
probably over long distances, by modern means of 
travel. This may explain the appearance of these in- 
sects in certain sections of the country which hereto- 
fore were free from them. 

Mosquitoes are particularly active at night. It is 
then they breed and bite more fiercely. During the 
day they collect in tall grass, bushes, etc., evidently to 
rest and escape from the light and heat and to find 
protection during rainstorms. Therefore the impor- 
tance of removing this growth, whenever it is practi- 
cable to do so, is manifest. 

The question is very naturally asked : By what 
means do mosquitoes perpetuate their species from one 
season to another? Some varieties, the yellow-fever 
mosquito, for example, which are found in tropical or 
very warm countries, propagate more or less through- 
out the entire year; while in sections where there are 
decided climatic changes, as in the middle or more 
northerly parts of the country, or wherever the tem- 
perature remains below 70° F. for an extended period, 



MOSQUITOES AND FLIES 217 

propagation ceases and most of them die. Some of 
the females, however, seek protected places, pass 
through the cold weather in a state of torpor, known as 
''hibernation," until springtime, when they become ac- 
tive again, seek a new breeding place, lay their eggs 
and die. This teaches an exceedingly important lesson 
that should be remembered ; that is, if breeding places 
are destroyed early in the season, and the hibernating 
females do not find a place to deposit their eggs, there 
will be during the following months no mosquitoes ex- 
cept the immigrating insects. The work of mosquito 
extermination, therefore, should begin very early in 
the year, and an extended and exhaustive inspection 
should be made to find and destroy the breeding 
places. 

In the case of the Atlantic Coast mosquito, on the 
other hand, a curious and interesting fact has within 
recent years been established. Instead of hibernating 
as the winged insect, it passes this stage in the egg 
form, which remains in the soil, and when the warm 
weather returns it hatches, and then passes through 
the various stages of development already mentioned. 

We have now learned sufficient concerning the mos- 
quito and its habits to provide efficiently for its ex- 
termination. It should be first ascertained what va- 
riety is being dealt with in order that the breeding 
places may be more readily found, and it must always 
be borne in mind that breeding places should be de- 
stroyed rather than treated. Sometimes when ground 
depressions and other forms of receptacles cannot be 
removed at once, recourse must be had to some tern- 



2i8 GOOD HEALTH 

porary agent for the destruction of the larvae. Petro- 
leum oil is the most valuable agent for this purpose. 
It does not poison the larvae, as is generally supposed, 
but kills them by suffocation. We have already learned 
that the larvae extend their tails above the water every 
minute for air. When the surface is covered with oil, 
the minute opening of the respiratory tract becomes 
plugged and death follows within a few minutes. 

Crude petroleum does not spread evenly over the 
surface of the water, for it is too thick. Therefore, 
semi-crude, or partly refined, oil, for instance, the 
brand known as 33 degree fuel oil, should be used for 
this purpose. This quickly forms a thin film over the 
surface. A pint of this material is ample to cover an 
estimated space of twenty-five feet in diameter. There 
is no better way of applying it than by the ordinary 
garden sprinkling pot with the holes in the expanded 
nozzle enlarged to permit the free exit of oil. This 
should be applied every ten days. As a protection 
against wetting the feet those who distribute the oil 
should wear rubber boots. There is no temporary 
agent which equals in value the oil for this purpose. 

In dealing with the breeding places of the striped- 
legged mosquito it is hardly necessary to state that 
the use of petroleum oil would be practically worth- 
less, for the salt water swamps are sometimes miles in 
extent, and it would be impracticable to attempt to 
cover the surface with oil. The extermination of this 
variety of mosquito must depend upon drainage, as this 
is the only way that the swamps can be kept sufficiently 
free of water to prevent propagation of mosquitoes. 



MOSQUITOES AND FLIES 



219 



Drainage for this purpose requires the construction 
of ditches about ten or twelve inches across, two feet 
deep, and from fifty to two hundred feet apart, depend- 
ing upon the character of the swamp land. When large 




Fig. 29. — Culex sollicitans. Salt water swamp, or striped-legged 
mosquito. 



areas are to be drained, the small ditches are made to 
connect with larger drains usually three or four feet 
wide, which conduct the water to the sea. It is true 
that the ditches become filled when the flood tide oc- 
curs, but the water remains for the most part in the 
ditches rather than on the surface of the swamp. The 
swamp also drains into the ditches, which are practi- 



220 GOOD HEALTH 

cally emptied at ebb tide. By this means permanent 
collections of water on the swamps are prevented. 

Suggestions are sometimes made that certain kinds 
of birds, bats and other insectivorous animals should 
be propagated for the destruction of mosquitoes. Vari- 
ous species of fish are also recommended for the de- 
struction of the larvae in pools and streams. Theoreti- 
cally, these might appear to be of value, but as a mat- 
ter of fact they are worthless, for even an enormous 
number of birds, which in itself would constitute a 
great nuisance, would accomplish little in the reduction 
of the number of winged insects. These theories, 
moreover, are harmful, for they divert public attention 
from the only method by which mosquitoes can be suc- 
cessfully exterminated, that is, the destruction of their 
breeding places, 

FLIES 

Flies are perpetuated from one season to another in 
a manner similar to mosquitoes, by the hibernation of 
the females, which seek warm protected places late in 
the season and remain dormant until springtime, when 
they become active again and seek some place to de- 
posit their eggs. Entomologists believe that flies are 
also perpetuated in the form of pupse, as well as the 
winged insect. 

The house fly (Musca domestica), with which we 
are particularly concerned, and which represents over 
ninety per cent of those found indoors, deposits prob- 
ably one hundred and fifty eggs at a time. Only ten 
or twelve days elapse between the dropping of the eggs 
and the appearance of the full grown insects. The fe- 



MOSQUITOES AND FLIES 221 

males of the new brood in their turn begin to lay their 
eggs in a few days after birth. The number of off- 
spring which a single female is accountable for during 
the season is incalculable ; it has been roughly estimated 
only as a matter of interest that within two or three 
months it would exceed 250,000,000. The development 
of the fly also is similar to that of the mosquito. First 
the eggs are deposited ; within twenty-four hours these 
are hatched and the larvae appear; after a further pe- 
riod of five or six days the latter pass to the pupal 
stage, and from this to the full-grown fly in three to six 
days. 

The larvae are well known as ^'maggots,'' and are 
about one-fourth to an inch long. They are white 
crawling bodies having the appearance of caterpillars. 
They are commonly found during the warm weather 
upon almost any manure heap, dead animal or other 
decomposing substance. The pupae are brown in color 
and bean-shaped, and are also present in great num- 
bers in oflfensive decomposing material. 

More recent investigation has proven that horse 
manure is a favorite breeding place for the fly. This 
knowledge is a valuable contribution to the subject and 
is of great aid in exterminating these insects or dimin- 
ishing their number. It follows that if stables are kept 
clean and manure promptly collected and placed in 
tightly covered receptacles while awaiting removal in- 
stead of being thrown about the premises, a very com- 
mon breeding place can be eliminated. However, it 
must not be forgotten that flies will breed wherever 
there is any kind of filth. Carelessness regarding ma- 



222 GOOD HEALTH 

nure heaps, privy vaults, garbage and any other forms 
of decomposing matter is responsible for the constant 
annoyance of flies in farmhouses and country homes. 
Yet it is here that the best sanitary results may be ob- 
tained; for it is only necessary for each family to 
abate its own nuisance to obtain relief from these in- 
sects, while in the city one must suffer from the care- 
lessness of others. 

The fly is not only a very annoying insect, but re- 
liable proof has been presented that it is also a medium 
of infection. For this reason the most energetic means 
should be taken to exterminate it. Flies are believed 
to be more or less accountable for the contamination 
of food and drink which often results in intestinal in- 
fection and which commonly occurs during the warm 
weather, principally among young children. Nearly 
5,000 deaths from this cause occurred in New York 
City during 19 10. 

There are many varieties of flies, some of which are 
dangerous. For instance, the Tsetse fly, found in 
Africa, transmits a very frequently fatal disease known 
as the ''sleeping sickness.'' This variety, as well as 
some of our domestic flies, bites ; however, the common 
house fly with which we are chiefly concerned does 
not. It has received the name of the ''typhoid fly," and 
is believed to be a frequent source of this infection, 
particularly in the country and in sparsely settled dis- 
tricts where privy vaults are in common use. While 
it is quite probable that the danger from this source is 
very much magnified, there is good reason to believe 
that it does exist. 



MOSQUITOES AND FLIES 223 

It is also reasonable to believe that milk, both in the 
city and the country, is contaminated by flies. This 
also applies to fruit whicli is exposed, for instance, at 
fruit stands and by street vendors. The selling of 
food and drink in public streets is very undesirable and 
insanitary, and is particularly dangerous to children. 
It is probably responsible for much of the sickness 
among them attributed to other causes. 

Unfortunately, the public has not a very clear under- 
standing as to the means by which flies may be elim- 
inated, or the object sought in carrying out this im- 
portant sanitary measure. Innumerable poisons, fly 
catchers, and ''swatters'' are on sale devised for the 
purpose of trapping or destroying flies. While these 
are very popular, they have little or no practical 
value, for as in the case of the mosquito, the exter- 
mination of flies can be successfully accomplished only 
by the destruction of their breeding places. 

School children are frequently called upon to assist 
in the destruction of flies. As already stated, that is 
also an impractical and unscientific means of elimina- 
tion, for the number destroyed in this way is so infini- 
tesimally small as compared with those not destroyed 
that the relief is entirely fanciful. Neither can this 
method be regarded as reliable or safe, for it gives 
children and others an incorrect idea of the way in 
which this work should be performed. Moreover, 
when children are encouraged to catch flies for 
remuneration, it is necessary to count the captured 
flies in order to determine the reward. The handling 
of flies in large quantities under these conditions is in 



224 GOOD HEALTH 

itself dangerous, for they wallow in filth, and it is not 
at all improbable that infection may result. Further- 
more, children should not be employed as scavengers. 

Children as well as adults can render valuable aid in 
the extermination of flies by reporting directly or indi- 
rectly to the municipal department of health the loca- 
tion of breeding places which have come under their 
observation. This enables the proper authorities to 
act promptly and effectively in removing these insani- 
tary conditions. 

Protection against the entrance of flies into the house 
and possibly subsequent infection cannot be success- 
fully secured by traps ; besides, the comparatively few 
caught by such means are not always ones which are 
dangerous as media of infection. The most practical 
way of dealing with this condition is the use of screens, 
which, curiously enough, are rarely constructed and 
adjusted to accomplish the purpose completely. 



CHAPTER Xlir 



TUBERCULOSIS 



There is no disease more familiar to the public than 
tuberculosis, also known as phthisis and consumption,, 
and it is the one which most commonly affects man- 
kind. Statistics show that probably one out of every 
seven deaths throughout the world is due to this dis- 
ease, and at least 150,000 persons in the United States 
succumb to it every year. 

From this rather depressing statement we turn to the 
most comforting part of the subject — the very definite 
knowledge concerning the means by which tuberculosis 
may be avoided, and the hope of recovery which is 
promised if the disease is detected early and the pa- 
tient promptly and carefully treated. 

Tuberculosis has been described in medical literature 
for centuries, and various theories have been suggested 
as to its origin and the means of transmission. That 
it is an infectious disease has long been suspected, for 
as early as the seventeenth century the bedding and 
clothing of consumptives were burned in order to pre- 
vent the possible danger from this source. Until recent 
years, the belief that tuberculosis is hereditary has been 
generally accepted, and its appearance among various 
members of a family has been explained in this way. 

225 



226 GOOD HEALTH 

Other theories as to the origin of this disease have 
from time to time been advanced, but the true cause 
was not definitely determined until about 1880, v^hen 
Professor Koch, of Germany, discovered that tubercu- 
losis is due to the presence of an organism known as 
the ''tubercle bacillus,'' a minute germ revealed only by 
the microscope. It is through the medium of this or- 
ganism that tuberculosis is conveyed from one person 
to another; therefore heredity plays no part in its 
transmission, except that a naturally weak resisting 
power may descend from parents to children, and in 
this way render them more susceptible to this as well 
as other diseases. This very clearly emphasizes the im- 
portance of maintaining a strong and healthful condi- 
tion of the body. 

It has been proved that animals and fowls have cer- 
tain forms of tuberculosis. It is only that which af- 
fects cattle, known as bovine variety, that concerns us, 
for the bovine bacillus is similar to that found in the 
human being, and may be transmitted through the me- 
dium of infected cow's milk. 

Children are frequently infected by cow's milk, and 
it is probable that one-quarter of all cases of tubercu- 
losis in children under the age of five years are con- 
tracted through this source. For various reasons adults 
rarely contract the disease in this way« The meat of 
diseased cows may also cause infection, although it so 
seldom occurs that it is practically a negligible factor. 
To a great extent, this is due to the fact that meat is 
cooked before it is eaten, and by this means the or- 
ganisms are quickly destroyed. Moreover, meat pre- 



TUBERCULOSIS 22J 

pared for sale is now subject to careful municipal, state 
or Federal inspection. While the transmission of the 
bacillus from infected cows may be a dangerous factor 
among very young children, it is insignificant in this 
respect in comparison with the infection conveyed 
from one person to another through the medium of 
sputum, by which means more than ninety per cent of 
all cases of tuberculosis are contracted. For this we 
are largely responsible, for if modern sanitary regula- 
tions were properly observed, the number of cases of 
the disease would be greatly reduced. 

Modern sanitation demands that cows shall be kept 
clean and under careful observation and that every 
reasonable means shall be taken to detect the presence 
of tuberculosis among them, for as in human beings 
this disease in its early stage is frequently overlooked. 
The tuberculin test constitutes a valuable scientific 
means of detecting tuberculosis in cows, for when this 
agent is injected a certain characteristic reaction fol- 
lows if the disease is present. Its accuracy in diag- 
nosis may be depended upon. As a rule there is no 
valid reason why owners of cows should not make use 
of this important means of protection. Cows should 
not be purchased unless a proper and satisfactory cer- 
tificate is presented to the effect that a tuberculin test 
has been made with a negative result. 

While tuberculous deposits may take place in various 
parts of the body, the disease usually occurs in the 
lungs, and it is with this form we are chiefly concerned. 
The germs upon reacliing the lungs as a rule multiply 
rapidly and cause local inflammation and subsequent loss 



228 GOOD HEALTH 

of tissue; the latter will account for the cavities in 
these organs so characteristic of the later stages of tu- 
berculosis. This broken down tissue containing tu- 
bercle bacilli is expelled with expectoration, and it is by 
this means that infection is transmitted. 

Much has been learned in regard to the germ itself. 
Experimental work has shown that tubercle bacilli, 
when exposed to the sunlight and fresh air, succumb 
within a very short time, but when the sputum is de- 
posited within the house, particularly when the apart- 
ments are in bad sanitary condition and there is but 
little light and ventilation, the germs may retain their 
vitality for considerable time, although not so long as 
it was formerly supposed. This admonishes us that the 
danger of contracting the disease is not in the open 
air, but rather within the house or workshop, for tu- 
berculosis is essentially an indoor disease. Further- 
more, tuberculosis is to a certain extent a class disease, 
for the conditions favorable to its propagation are 
more often found among the poor who are by far the 
most frequent victims of consumption. 

The means by which infection takes place in tuber- 
culosis or rather the avenues through which the tu- 
bercle bacilli most frequently reach the lungs, is still 
undecided. Recent investigation has thrown consider- 
able doubt upon the former theory that the infectious 
organisms are transmitted directly to the lungs through 
the respiratory tract or the bronchial tubes. It is now 
believed that the bacilli reach these organs not only 
through the air passages, but also through the stomach 
and intestinal tract, by swallowing infectious organ- 



TUBERCULOSIS 229 

isms, and also by taking contaminated food and drink. 
This theory, which is reasonable and logical, is slowly 
but surely gaining ground. Furthermore, there is very 
satisfactory proof that the danger of contracting tuber- 
losis through the medium of outside air and dust has 
been greatly exaggerated ; to a certain extent this may 
be said of house dust. 

The consensus of opinion among those who have 
given this subject careful and exhaustive investigation, 
is that the germ of tuberculosis usually enters the body 
by contact. By this is meant the transmission of in- 
fectious germs directly from one person to another or 
by persons within a very short distance of each 
other, as by droplets or sprays. This includes various 
means, such as kissing, contaminated hands, various 
articles applied to the mouth which are used in com- 
mon, and food and drink containing the tubercle bacilli. 

The lesson to be learned from this is that persons 
and not things transmit tuberculosis, that we need not 
worry about clothing, money and other articles, for 
there is practically no danger from this source. Every 
reasonable effort should be made to prevent exposure 
to fresh pulmonary discharges from tuberculosis pa- 
tients, and there is no more important factor in 
maintaining this protection than cleanliness. 

The question is very naturally asked: Why, if the 
germs of consumption are so generally distributed, do 
so many of us escape infection? The truth is we do 
not escape it, for it is quite certain that a large per- 
centage of all who have reached adult life, particularly 
those who live in cities and large towns where there is 



230 GOOD HEALTH 

close association among people, have been infected 
with this organism, although only a certain proportion 
present definite evidence of the disease. This is 
largely due to the resisting power of the body which 
under normal and healthy conditions permits the bacilli 
to make little or no headway. This is also observed 
in connection with the germs of other infectious dis- 
eases. On the other hand, it is well known that tuber- 
culosis very commonly follows a debilitating disease, 
such as typhoid fever or a condition which for the time 
being has diminished the vital forces. 

The importance of maintaining a natural resistance 
to tuberculosis, as well as to other diseases, in the way 
of a proper observance of the rules of personal hygiene 
cannot be overestimated. This does not mean that we 
should live in a restricted and unnatural way, but only 
that we should preserve a normal condition of health. 

Beyond careful attention to practical and logical pre- 
cautions in the prevention of tuberculosis, we should 
dismiss the fear of it from our minds and not expect 
to find infection lurking everywhere, for this is not 
the case. 

The cure for tuberculosis depends chiefly upon the 
recognition of the disease in its early stage. Then it 
is far more successfully dealt with, as comparatively 
little lung tissue is involved in the process of destruc- 
tion and the general health of the patient is not so 
seriously impaired. 

There is no disease where recovery rests so largely 
in the hands of those affected, for there is no medi- 
cine, vaccine, serum or other agent which can be de- 



TUBERCULOSIS 231 

pended upon for the treatment or cure of tuberculosis- 
Advertisements relating to so-called consumption cures; 
are being constantly presented to the public. These 
nostrums are offered for sale with the most attractive 
testimonials. If those who are being misled by these 
worthless agents could know of the lives that are an- 
nually lost by depending upon them, when it is too late 
to derive benefit from proper sources, it would go far 
toward eliminating this menace to public health. 

While the cure of tuberculosis depends greatly upon 
the efforts of those who are affected, it is essential that 
such persons should be under medical direction and 
supervision, and very frequently so, until they have 
learned to take proper care of themselves. 

It is not expected that a layman will be able to rec- 
ognize tuberculosis in its early stages, but such symp- 
toms as loss of weight and appetite, irritability, fatigue 
and continued cough should be regarded as a warning 
and a physician promptly consulted to determine 
whether or not there is any evidence of pulmonary 
trouble. In the beginning of the disease attention may 
not be attracted to the lungs. Dependence upon domes- 
tic remedies at this time is unfortunately widespread 
and is to be condemned, for it is very apt to prevent 
an early diagnosis of the case. This does not refer 
to the careful and valuable nursing one may receive 
at home after the disease has been identified. 

It is very important that those who are infected with 
tuberculosis should bear in mind that the principal 
factors in the cure of this disease are an abundance of 
good food, fresh air and rest. Unfortunately, these 



:232 GOOD HEALTH 

means are not always available, and it is largely for 
this reason that recovery does not more often take 
place. Tuberculosis patients should also understand 
that they are media of infection and it is only fair to 
the public that they should take every reasonable pre- 
caution to prevent the spread of the disease, chiefly 
by cleanliness. 

As infection is transmitted chiefly through the dis- 
charges from the respiratory tract, the sputum, or 
spittle, should be received in receptacles or upon some 
material which is carefully protected and promptly de- 
stroyed by burning. Innumerable and inexpensive de- 
vices for this purpose may be purchased almost 
anywhere. Cuspidors are not regarded as a modern 
sanitary device and when used for the reception of the 
sputum of tuberculosis patients are very liable to act 
as foci of infection. 

It is also very important that the hands of the pa- 
tient, which are sure to be contaminated and are in fre- 
quent contact with members of the family and others, 
should be kept thoroughly cleansed with soap and 
water. Articles which have been applied to the mouth 
of tuberculosis patients and material which has been 
soaked with sputum should be burned or treated with 
boiling water or steam. 

The foregoing constitutes in a general way the pre- 
ventive measures to be followed in dealing with tuber- 
culosis. However, in each case there are special details 
to be considered which come rather within the province 
of the family physician. 

It is frequently asked if a tuberculosis patient can re- 



TUBERCULOSIS 233 

main at home with safety to other members of the 
family. This may be answered in the affirmative, pro- 
vided every reasonable care is taken by the patient as 
well as the various members of the family to prevent 
the transmission of the disease. 

If modern sanitary methods are employed in con- 
nection with the care of patients suffering from tuber- 
culosis, there is no good reason why general disinfec- 
tion in the house should be performed. However, 
treatment of this kind is often advised by health offi- 
cials, although there is usually little or no justification 
for it. In instances where medical advice is not avail- 
able, a general and thorough cleaning with soap and 
water will extend the needed protection. 

In cities and large towns dispensaries and clinics 
may be found for the treatment of the poor. There- 
fore in these places there is no reason why a person in 
any station of life should not be able to obtain proper 
medical attention. 

It is the duty of employers to observe carefully the 
physical condition of their employees. If this is done 
tuberculosis may be detected. This is not only in the 
interest of those who may be affected, but also for the 
protection of fellow workers. It is also to the advan- 
tage of the employers, for a minimum amount of 
sickness among those in their service means more sat- 
isfactory and less interrupted work, and really consti- 
tutes an economic factor. 

Under certain conditions and in the incipient stages 
of this disease, with the approval of a physician, tu- 
berculosis patients may continue their work without 



234 GOOD HEALTH 

special injury to themselves or others, provided they 
are under careful modern observation. 

Parents and guardians have an important duty to 
perform in regard to tuberculosis, for this disease oc- 
curs principally in early life and any apparent devia- 
tion in the health of those under their care should call 
for prompt and thorough physical examination. 



CHAPTER XIV 

DISINFECTANTS AND DEODORANTS 

A DISINFECTANT IS an agent which destroys the 
germs or organisms with which it comes in contact. 
An antiseptic retards the growth of germs but does 
not necessarily kill them. A deodorant neutralizes of- 
fensive odors, but is not necessarily destructive to 
bacteria. 

A large number of preparations advertised for sale 
as disinfectants are worthless, and while some may be 
germ destroyers, their use in the house for general san- 
itary purposes is unnecessary and far less valuable than 
cleanliness. Besides, disinfectants are demanded only 
in the presence of infectious disease. 

There are several dependable disinfectants, such as 
carbolic acid and corrosive sublimate, yet of all known 
agents of this kind, heat is the most valuable and cer- 
tain in its action. Heat in some form is always avail- 
able; it is safe and its expense is a negligible factor. 
Steam and boiling water are the most practical methods 
of using heat for disinfecting purposes. Boiling water 
is best adapted for home use, while steam is employed 
for public disinfection. In the latter case an appa- 
ratus is required which is more or less complicated and 
expensive. 

235 



236 GOOD HEALTH 

It has already been explained that infectious diseases 
are transmitted through the media of the discharges of 
those who are sick. Therefore if this condition occurs 
and a physician is not promptly available, much can be 
done by the family in preventing the extension of in- 
fection by heating articles and material used about the 
patient, which are presumably contaminated by the dis- 
charges. If this is properly performed all germs thus 
exposed will be destroyed. 

Simple and inexpensive gas or oil stoves may now 
be purchased almost anywhere, and a wash pan or some 
form of metal receptacle for boiling the water can be 
found in every home. It is true that boiling water can- 
not be applied to the skin for the destruction of infec- 
tious organisms which may be present on the surface 
of the body, but soap and hot water may be used with 
almost equal value. 

It should be remembered that articles or material to 
be disinfected by boiling water must be kept in water 
which must he constantly boiling for at least five min- 
utes. Simply placing the articles in the boiling water 
which is allowed to cool does not always insure dis- 
infection. A small amount of lime placed in a recep- 
tacle will usually prevent any unpleasant odor during 
disinfection. This treatment should be carried out in 
the sickroom or one adjoining in order to prevent the 
transmission of infectious material to others. 
• In addition to the use of boiling water as a disin- 
fectant, it is important that the hands of those in 
charge of the sickrpom should be kept well washed in 
soap and water, particularly upon leaving the apart- 



DISINFECTANTS AND DEODORANTS 237 

ment to mingle with others. If the patient is prop- 
erly isolated, there is little in the way of further pre- 
cautionary measures that the doctor can add upon his 
arrival. 

Antiseptics, as has already been explained, are agents 
which are less destructive to germs than disinfectants, 
and are used by physicians under various conditions 
which need not be discussed here. 

Deodorants under ordinary conditions are not re- 
quired about the house, for filth which generates of- 
fensive odors should be removed and not treated. 
Sometimes, however, there may be collections of filth, 
dead animals, etc., about the premises, which for the 
moment cannbt be removed. In these emergencies deo- 
dorants are called for. 

A true deodorant is one which destroys oflfensive 
odors by neutralizing and not masking them with a 
stronger odor. Bromin at one time was regarded as 
the most effective agent for this purpose, but its use 
is rather dangerous, for it violently irritates the respir- 
atory tract, so much so that in making solutions for 
deodorizing purposes it is necessary to break the bottle 
containing the bromin under water. Besides, the effect 
of bromin is not lasting. 

Lime is also an excellent deodorant, but it is usually 
employed in the form of a powder known as chlorid of 
lime. A deodorant of this kind is far less penetrating 
and effective than one in fluid form. Probably the 
most valuable and simple deodorant is prepared by 
mixing one pound each of lime and copper with ten 
gallons of water. Copper is valuable as a deodorant 



238 GOOD HEALTH 

because it has a strong affinity for sulphur. Offensive 
odors emanating from decomposed organic matter are 
usually due to the formation of a sulphur compound 
with which copper forms insoluble products. 

Ordinarily sulphate of copper, or blue vitriol, costs 
about five cents a pound, and unslaked, or rock, lime, 
may be purchased for three cents a pound. Therefore, 
this ten-gallon mixture costs only eight cents. Lime 
may be obtained either in barrels or tin cans. That 
purchased in cans is preferable, as it is better protected 
against the entrance of air. Lime which has been ex- 
posed, known as air-slaked lime, should never be used. 
The lime required for the above purpose must not be 
confused with chlorid of lime. 

In preparing this mixture in sufficient quantities for 
a stock solution, it is advisable first to dissolve the cop- 
per by placing it in a linen bag suspended by a string 
in the cask or receptacle just below the surface of the 
water. The copper may be dissolved in six or eight 
gallons of water, leaving the remainder of the ten gal- 
lons for mixture with the lime. This is done by placing 
the lime in a pail or other receptacle, and gradually 
adding water and stirring until the steaming or slak- 
ing is completed. The solution of lime is then gradu- 
ally added to the water in which the copper has been 
dissolved. 

Precipitation always takes place and it is necessary 
to stir the mixture thoroughly before it is removed 
from the receptacle. The mixture should be kept in a 
tightly closed receptacle to prevent evaporation. 

In the treatment of offensive material, such as de- 



DISINFECTANTS AND DEODORANTS 239 

composed organic matter, dead animals, fish, garbage 
heaps, offensive vaults, etc., no complicated apparatus 
is necessary for the application of this mixture. An 
ordinary good-sized sprinkling pot is sufficient for the 
purpose. As the mixture is rather thick, it is best to 
enlarge the holes in the sprinkler with an awl or some 
similar instrument. In treating large collections of of- 
fensive fluids, the sprinkling pot is not required ; add 
one gallon of the deodorizing mixture to thirty or fifty 
gallons (estimated) of the fluid to be treated. 

The most prompt and gratifying results may be ex- 
pected in using this mixture as a deodorant. A second 
application is not usually required, although it may be 
added as often as it is deemed desirable. Frequently 
the mixture will adhere to or stain the various parts of 
material to which it is applied; this may afterwards 
be removed by a stream of water. This also applies to 
textile fabrics. 

It is often desired to destroy insects which may be 
present in an apartment; for this purpose there is no 
more effective agent than sulphur dioxid gas, which is 
generated by burning the ordinary rolled sulphur. This 
can be purchased for three or four cents per pound 
anywhere. About four pounds of it should be burned 
for every thousand cubic feet of space ; for instance, a 
room ten feet square and ten feet high. Great care 
should be used in preparing the sulphur for combus- 
tion, for the least amount is very irritating to the res- 
piratory tract. Besides, if care is not used there is 
danger of igniting some article about the room. 

An apparatus for burning the sulphur may be impro- 



240 GOOD HEALTH 

vised in any home. On the bottom of an ordinary 
wash tub are placed two or three bricks to support a 
metallic receptacle for the sulphur, such as the ordinary 
milk-pan or a galvanized wash basin. The tub should 
be filled with water to a height just above the bricks 
and the bottom of the receptacle; otherwise, the lat- 
ter may be burned as well as the floor. By this ar- 
rangement the spluttering of the burning sulphur is far 
less liable to cause fire. In order to secure as far as 
possible the complete combustion of sulphur, it should 
be broken into very small pieces, over which alcohol 
should be freely poured. Methyl or wood alcohol, 
which is inexpensive, will answer the purpose. After 
the alcohol has been applied it should be ignited by 
dropping a lighted match or piece of paper upon it, 
the operator at the time standing as far as possible 
from the receptacle. If alcohol cannot be obtained, a 
lighted coal may be placed in the mass, although the 
method is far from satisfactory. 

Before the sulphur is ignited all the windows and 
doors in the apartment except, of course, the door for 
the exit of the operator, should be carefully closed and 
sealed. This can be accomplished with strips of news- 
paper about two inches wide made fast with common 
flour paste; after leaving the room, the exit door 
should be similarly sealed. These seals are afterwards 
easily removed. There should be an exposure of six 
hours. At the end of this time the door should be care- 
fully opened by someone having a wet sponge or towel 
held to his nose and mouth, to protect him against the 
remaining gas. Even after six hours, there is usually 



DISINFECTANTS AND DEODORANTS 241 

enough sulphur dioxid left in the apartment to irritate 
the respiratory tract and the eyes. A window should 
be quickly opened, the door again closed and the re- 
mainder of the gas allowed to escape. 

Sulphur dioxid gas cannot be depended upon to pen- 
etrate; therefore, articles which are supposed to con- 
tain certain bugs or insects should be freely exposed. 
It is advisable that the gas should be generated during 
the day in order that the room may be freed of it be- 
fore bedtime, for leaks are possible through windows 
and doors, and unpleasant results might occur during 
the night. 

Sulphur dioxid gas is commonly used for room dis- 
infection at the termination of a case of infectious dis- 
ease, although there is but little or no justification for 
this procedure. 



CHAPTER XV 

PROMPT AID TO THE INJURED 

The object of prompt aid in the presence of injury 
or sudden illness is to provide immediate assistance 
and relief until the doctor arrives. It is not expected 
that laymen shall be familiar with the scientific meth- 
ods of treating the various injuries which may occur, 
nor is it proper for those who render prompt aid to 
assume that they are competent to continue the treat- 
ment of emergency cases which come under their care, 
for they are not; and any attempt to do this not in- 
frequently becomes a source of danger. This is jus- 
tifiable only in instances where physicians are not 
quickly available. 

To render prompt aid successfully, it is necessary to 
know something of the emergencies which are usually 
met with and the principles under which they are 
treated. At the same time it is important to remember 
that when an injury takes place, unless there is good 
evidence that it is of a most trivial character, it should 
be promptly placed under the care of a physician. 

Prompt aid relates chiefly to the following condi- 
tions : 

Hemorrhage 
Shock or collapse 
242 



PROMPT AID TO THE INJURED 243 

Fainting 

Apoplexy or stroke of paralysis 

Epilepsy 

Hysteria 

Asphyxia 

Drowning 

Burns and scalds 

Fractures and dislocations 

Poisoning 

HEMORRHAGE 

Hemorrhage calls for the most energetic action, for 
beyond a certain point the loss of blood leads to a fatal 
result. 

Hemorrhage is classified as arterial, venous, and 
capillary. It is very important to know the difference 
between these types, for upon this largely depends the 
successful treatment of this condition. 

In arterial hemorrhage, the blood which is on its 
way from the heart, having just been purified in the 
lungs by the oxygen in the air, is a bright red color, 
and with the force of the heart directly propelling it, is 
thrown out in jets and spurts. In venous hemorrhage, 
the blood flows from the wound in a slow steady 
stream, for it is much farther removed from the ac- 
tion of the heart and therefore receives much less 
force. Venous blood contains various impurities or 
waste matter taken up from the tissues of the body, 
and is deficient in oxygen, and for this reason is blu- 
ish in color. 

Capillary hemorrhage, or oozing, comes from the 



244 GOOD HEALTH 

very small blood-vessels, and except in the case of 
bleeders is not of a very serious character. It is 
usually controlled without difficulty. 

Treatment, — In arterial hemorrhage where a good- 
sized vessel is involved, physicians tie or ligate the ar- 
tery. It is hardly necessary to state that this is not to 
be attempted by laymen who render prompt aid. How- 
ever, a valuable temporary substitute to be employed is 
in the form of pressure. In most instances if this is 
properly applied it will successfully control the bleeding 
until the physician arrives. 

In order to apply pressure in the proper manner, 
one must be familiar with the points where arterial 
trunks or main arteries come close to the surface of 
the body and may be easily found. For this reason 
the accompanying chart (Fig. 30) has been prepared 
and should be carefully studied. 

Pressure should always be made between Xh^ heart 
and the wound in arterial hemorrhage. Digital pres- 
sure, or that made with the fingers or thumbs, is the 
most efifective, but it is available only for a short time, 
unless the person making the pressure can be relieved 
at short intervals. If the surgeon is expected to ar- 
rive promptly, digital pressure should be depended 
upon, for it is safest and most effective, as the artery 
can be felt and the pressure kept in the right place. 
In digital pressure the thumb is generally used. 

If considerable time is expected to elapse before 
the doctor arrives, and there is not a sufficient number 
of persons present to maintain digital pressure, a 
firm resisting pad may be applied directly over the 




Fig. 30.— Diagram showing the position of the important arteries. 



PROMPT AID TO THE INJURED 245 

trunk of the bleeding artery. The most efifective means 
of securing this result is in the form of a tourniquet, 
an instrument prepared specially to arrest hemorrhage 
by compression. 

A serviceable improvised tourniquet or compressor 
may be made by folding a large handkerchief in the 
form of a cravat and placing between its folds a 
smooth round stone, piece of wood, cork, potato, etc., 
or a good-sized knot tied in the handkerchief. The 
latter, however, is inferior to the others mentioned. 
The handkerchief is then loosely bound around the 
limb and tied, the portion acting as the pad being 
placed directly over the trunk of the artery between 
the wound and the heart. The artery can be located 
by its pulsation. The pad is held securely in position 
while a stick, cane, bayonet, sword, or other article 
available for this purpose is passed between the hand- 
kerchief and the skin on the side of the limb opposite 
the pad, and twisted slowly and carefully until the 
hemorrhage ceases or is greatly lessened. As the con- 
striction resulting from this form of pressure is likely 
to interfere with the return, or venous, circulation, the 
tourniquet should be occasionally loosened if there is 
danger of serious obstruction. If swelling and blue- 
ness of the part below the point of hemorrhage be- 
comes too pronounced digital pressure should be sub- 
stituted for a short time. A handkerchief is given as 
an illustration of what is usually available for this 
purpose, although parts of clothing, neckties, suspend- 
ers, rubber tubing or other material are equally good, 
provided they fulfill the requirements. 



246 GOOD HEALTH 

Venous hemorrhage is far more easily controlled 
than arterial hemorrhage, for the pressure within the 
vessels is far less. It may be successfully dealt with 
in the following manner: 

1. Remove every restriction between the wound 
and the heart, for venous blood flows towards the 
heart. 

2. Elevate the injured part. 

3. Apply a good firm compress directly over the 
wound. 

Constriction of the limb beyond the seat of hemor- 
rhage or toward the end of the extremity is valuable, 
but far inferior to direct pressure. The free return of 
blood to the right side of the heart is aided by the ele- 
vation of the limb which relieves the blood pressure 
in the veins in the immediate vicinity of the wound, 
and consequently the hemorrhage is not so profuse. 

Capillary hemorrhage is usually not dangerous and 
generally ceases when pressure is applied or when the 
bleeding surface is exposed to the air. It may be suc- 
cessfully dealt with by a compress. 

Cold is also a very valuable means of controlling 
venous and capillary hemorrhage, and aids in prevent- 
ing bleeding from the small arteries. It may be ap- 
plied in the form of cold water, ice and snow. 

Hot, not warm, applications — temperature 120° to 
125° F. — may also be used for this purpose. A piece 
of clean flannel wrung out in water as hot as can be 
borne by the skin and applied directly to the bleeding 
surface is usually followed by a diminution or a ces- 
sation of hemorrhage. Both hot and cold applications 



PROMPT AID TO THE INJURED 247 

contract the bleeding vessels, and hasten the formation 
of the blood clot, one of nature's means of arresting 
hemorrhage. 

Styptics or astringents, such as preparations of iron, 
silver, tannin and alum, although effective agents in 
arresting venous or capillary hemorrhage, are used by 
surgeons with great reluctance and only in special 
cases or where other means are not available or ef- 
fective. They prevent the early healing of the wound, 
and their use may be followed by sloughing. Alum is 
one of the least .objectionable of this group. 

The application of astringents to mucous mem- 
branes (mouth, nose, etc.) is followed by more fa- 
vorable results than when applied to a raw surface. 

Rest is extremely important in all varieties of hem- 
orrhage as it favors the formation and retention of 
the blood clot. 

Hemorrhage in the scalp is easily arrested by the 
use of a compress and bandage which press the bleed- 
ing vessels against the underlying skull. 

Slight hemorrhage from the mouth may usually be 
stopped by the local use of ice and astringent (alum, 
tannin), sometimes by alcohol (brandy, whisky, etc.)- 
If these agents are not efficacious, a tampon or pad 
should be held firmly against the bleeding part. In 
severe cases, the large artery in the neck (see Fig. 30) 
of the same side as the injury may be compressed, 
although this only should be done as a last resort. 

The lips are supplied with arteries which divide at 
the angles of the mouth and entirely surround the 
mouth. When the lips have been injured, the hemor- 



24S GOOD HEALTH 

rhage may be checked by pressing the sides of the 
wound between the thumb and fingers. 

Severe hemorrhage following the extraction of a 
tooth can usually be controlled by the application of 
a tampon or plug saturated with a strong solution of 
alum, tannin or other astringent and placed in the 
cavity. 

Epistaxis, or nose bleed, is the most frequent form 
of internal hemorrhage, and as a rule may be controlled 
in one or more of the following ways : Elevation of 
the head and the arms, removal of all restriction about 
the neck, cold applications to the back of the neck, 
forehead or sides of the nose. Passing two fingers 
beneath the upper lip and directing pressure against 
the base of the nostrils or nose is very useful. Snuf- 
fing up some finely powdered tannin or alum water is 
often employed with benefit. 

A very valuable method of checking severe epistaxis 
is by the use of a clean, thin, rubber finger-cot or pro- 
tector which should be oiled and carefully passed into 
the nasal cavity of the afifected side. After the cot 
is in position it should be filled or partly filled with 
very small pieces of ice. 

In severe cases of epistaxis which resist the reme- 
dies already enumerated and where the doctor is not 
expected promptly, the affected nasal cavity may be 
tamponed or plugged by carrying into it a piece of 
clean gauze — antiseptic if possible — over a pencil or 
other agent for this purpose. When the pencil is with- 
drawn, the cavity left in the gauze is packed with small 
pieces of cloth or cotton. The tampon should be left a 



PROMPT AID TO THE INJURED 249 

number of hours and never forcibly removed, but 
should be loosened by injection of water or oil. 

SHOCK— COLLAPSE 

Shock is a condition resulting from a severe im- 
pression made upon the nervous and circulatory sys- 
tems either by a physical injury or a mental disturb- 
ance. The majority of cases dealt with are the result 
of extensive burns or other grave injuries, such as gun- 
shot wounds and railway accidents. Electric shock is 
also quite common. Severe shock may be produced by 
fright alone. 

Shock may be of a mild character where the symp- 
toms are hardly noticeable, or it may be rapidly fatal. 
In slight shock the face is pale, the pulse is weak and 
slight nausea may be present; a general feeling of de- 
pression always occurs. In serious cases, the extreme 
pallor and coldness of the skin is very pronounced; 
the body is covered with moisture ; the pulse at the 
wrist may be lost, or if perceptible, is very weak, 
irregular and rapid; the features are shriveled, par- 
ticularly about the nose which seems pinched ; the eyes 
are sunken and turned upwards, and the finger nails 
are of a bluish color. The patient is conscious, but 
dazed and flighty, and apparently appreciates only 
loud and repeated questions, and sensibility to pain 
is very much blunted. 

In cases which end favorably, there appear, usually 
within an hour or so, symptoms denoting an increase 
in the strength of the heart and circulation. This 
change is known as reaction and generally indicates. 



250 GOOD HEALTH 

as far as the shock is concerned, a favorable termi- 
nation; although other results of the injury may be 
fatal. 

Treatment. — As an illustration, it may be supposed 
that a man has been injured in a railway accident and 
is found in a condition of shock. Those who attend 
the case should at once loosen the clothing and make 
a rapid but careful examination to ascertain if hemor- 
rhage exists or if some condition is present which calls 
for immediate action. If for any reason it becomes 
necessary to move the patient, his head should be kept 
as low if not lower than the body to favor the flow 
of blood towards the brain. If possible, four per- 
sons should arrange to carry the patient to insure 
greater protection. If the examination indicates that 
a bone has probably been broken, a temporary splint 
should be used to prevent the movement of the frag- 
ments of the bones during transportation. (See Frac- 
tures.) Arriving at the place selected, the clothing 
should be quickly and carefully removed or cut away 
if necessary to avoid delay. Then the patient should 
be placed in a warm bed if available, his head being 
kept low ; blocks under the foot of the bed will accom- 
plish this. 

The treatment now consists in applying warmth to 
the surface of the body and in carefully administering 
some form of internal stimulation. The first indica- 
tion can be met by surrounding the patient with hot 
water bottles, or hot bricks, stones, etc., about the 
arms and legs, thighs and body, but not about the 
head, for when reaction occurs, this added heat may 



PROMPT AID TO THE INJURED 251 

favor a congestion of the brain. It must be remem- 
bered that the sensibility of the patient is blunted and 
these articles may burn without the patient knowing 
it; therefore they should be carefully watched. A hot 
plate wrapped in a towel may be placed over the heart, 
and when vomiting occurs, a mustard plaster may be 
applied for a short time over the stomach. Although 
friction may disturb the patient, it can be resorted to 
when heat cannot be supplied as indicated above. 

The second indication, the use of internal stimula- 
tion, is of course governed by the condition of the 
patient. If he is able to swallow he should be given 
about two teaspoonfuls of whisky or brandy with some 
hot water; this may be repeated every jfifteen minutes 
until three or four doses have been taken, or reaction 
becomes evident. Persons suffering from shock are 
sometimes unable to swallow ; this should be carefully 
ascertained before giving anything by the mouth, as 
strangulation may ensue. In such cases, two table- 
spoonfuls of brandy or whisky in a cupful of warm 
water may be introduced into the rectum by the ordi- 
nary rectal syringe, and repeated in fifteen or twenty 
minutes. In place of this, an injection of a cupful of 
strong coffee may be employed; this is very valuable. 
A pint of water as hot as can be borne by the hand, in- 
jected into the rectum is also of benefit. 

Electric Shock 

Treatment. — In recent years the enormous increase 
in electrical work of various kinds has been responsible 
for many cases of accidental electric shock. 



252 GOOD HEALTH 

The treatment of this condition has been very ably 
dealt with by the National Electric Light Association 
in the form of published rules for guidance in dealing 
with these emergencies. The following are extracts : 

An accidental electric shock usually does not kill at 
once, but may only stun the victim and for a while stop 
his breathing. 

The shock is not likely to be immediately fatal, because : 

(a) The conductors may make only a brief and imper- 
fect contact with the body. 

(b) The skin, unless it is wet, offers high resistance 
to the current. 

Hope of restoring the victim lies in prompt and con- 
tinued use of artificial respiration. The reasons for this 
statement are: 

(a) The body continuously depends on an exchange of 
air, as shown by the fact that we must breathe in and 
out about fifteen times a minute. 

(b) If the body is not thus repeatedly supplied with 
air, suffocation occurs. 

(c) Persons whose breathing has been stopped by elec- 
tric shock have been reported restored after artificial 
respiration has been continued for approximately two 
hours. 

The Schafer, or ''prone pressure" method of artificial 
respiration, slightly modified, is illustrated and described 
in the following resuscitation rules. The advantages of 
this method are: 

(a) Easy performance; little muscular exertion is re- 
quired. 

(b) Larger ventilation of the lungs than by the supine 
method. 



PROMPT AID TO THE INJURED 253 

(c) Simplicity; the operator makes no complex motions 
and easily learns the method on first trial. 

(d) No trouble from the tongue falling back into the 
air passage. 

(e) No risk of injury to the liver or ribs if the method 
is executed with proper care. 

Aid can be rendered best by one who has studied the 
rules and has learned them by practice on a volunteer 
subject. 

Instructions for Resuscitation 

Follow these instructions even if victim appears dead, 
I, Break the Circuit Immediately, — With a single quick 
motion separate the victim from the live conductor. In 
so doing avoid receiving a shock yourself. Many have, 
by their carelessness, received injury in trying to dis- 
connect victims of shock from live conductors. 
Observe the following precautions: 

(a) Use a dry coat, a dry rope, a dry stick or board, 
or any other dry non-conductor to move either the victim 
or the wire, so as to break the electrical contact. Beware 
of using metal or any moist material. The victim's loose 
clothing, if dry, may be used to pull him away; do not 
touch the soles or heels of his shoes while he remains in 
contact — the nails are dangerous. 

(b) If the body must be touched by your hands, be sure 
to cover them with rubber gloves, mackintosh, rubber 
sheeting or dry cloth ; or stand on a dry board or on some 
other dry insulating surface. If possible, use only one 
hand. 

If the victim is conducting the current to ground, and 
is convulsively touching the live conductor, it may be 
easier to shut off the current by lifting him off the ground 
and trying to break his grasp. 



254 GOOD HEALTH 

Open the nearest switch, if that is the quickest way to 
break the circuit. 

If necessary to cut a live wire, use an ax or a hatchet 
with a dry w^ooden handle, or properly insulated pliers. 

2, Send for the Nearest Doctor, — This should be done 
without a moment^s delay, as soon as the accident occurs, 
and while the victim is being removed from the conductor. 

J. Attend Instantly to Victim's Breathing, — (a) As 
soon as the victim is clear of the live conductor quickly 
feel with your finger in his mouth and throat and remove 
any foreign body (tobacco, false teeth, etc.). Then begin 
artificial respiration at once. Do not stop to loosen the 
patienfs clothing; every moment of delay is serious. 

(b) Lay the subject on his belly, with arms extended 
as straight forward as possible, and with face to one side, 
so that the nose and mouth are free for breathing (see 
Fig- 31). Let an assistant draw forward the subject's 
tongue. 

If possible avoid so laying the subject that any burned 
places are pressed upon. 

Do not permit bystanders to crowd about and shut off 
fresh air. 

(c) Kneel, straddling the subject's thighs and facing 
his head; put the palms of your hands on the loins (on 
the muscles of the small of the back), with thumbs nearly 
touching each other, and with fingers spread over the low- 
est ribs (see Fig. 31). 

(d) With arms held straight, swing forward slowly 
so that the weight of your body is gradually brought to 
bear upon the subject (see Fig. 32). This operation, 
which should take from two to three seconds, must not he 
violent — internal organs may be injured. The lower part 
of the chest and also the abdomen are thus compressed, 
and air is forced out of the lungs. 




Fig. 31.— Artificial respiration: inspiration. Pressure off. 




Fig. 32. — Artificial respiration: expiration. Press 



255 



256 GOOD HEALTH 

(e) Now immediately swing backward so as to remove 
the pressure, but leave your hands in place, thus returning" 
to the position shown in Fig. 31. Through their elas- 
ticity, the chest Vv^alls expand and the lungs are thus 
supplied with fresh air. 

(f) After two seconds swing forward again. Thus 
repeat deliberately twelve to fifteen times a minute the 
double movement of compression and release — a complete 
respiration in four or five seconds. If a watch or a clock 
is not visible, follow the natural rate of your own deep 
breathing — swinging forward with each expiration, and 
backward with each inspiration. 

(While this is being done, an assistant should loosen 
any tight clothing about the subject's neck, chest, or 
waist.) 

(g) Continue artificial respiration (if necessary, two 
hours or longer), without interruption, until natural 
breathing is restored, or until a physician arrives. Even 
after natural breathing begins, carefully watch that it 
continues. If it stops, start artificial respiration again. 

During the period of operation keep the subject warm 
by applying a proper covering and by laying beside his 
body bottles or rubber bags filled with warm, not hot, 
water. The attention to keeping the subject warm should 
be given by an assistant or assistants. 

(h) Do not give any liquids whatever by mouth until 
the subject is fully conscious, 

SYNCOPE— FAINTING 

Syncope, or fainting, is a condition of suspended 
animation associated with a great diminution of blood 
in the brain and unconsciousness caused by sudden 
enfeeblement of the heart's action. 



PROMPT AID TO THE INJURED 257 

Fainting may be the result of disease of the heart, 
hemorrhage, pain, excessive emotion, tight lacing, in- 
digestion, hunger, exhaustion, hot and vitiated air, 
and many other causes. Before the stage of uncon- 
sciousness is reached, the person afifected experiences 
a weak and sinking feeling with dizziness, dimness of 
vision and roaring in the ears. The face and extremi- 
ties become cold and clammy. 

The stage of unconsciousness may last a few sec- 
onds or an hour or more depending upon the cause. 
During this period, the pulse is weak and almost lost 
and the respiration is very shallow or may apparently 
cease. Fainting is of very common occurrence and is 
usually not associated with danger. 

Treatment. — The patient should be placed in a re- 
cumbent position with the head as low or lower than 
the body to favor the flow of blood towards the brain. 
Fresh air is a very essential element in the treatment 
of fainting. All tight clothing, such as collars, corsets, 
skirts or trousers, should at once be loosened. In the 
ordinary forms of fainting due to simple causes, this 
treatment is all that is required, for nature very soon 
asserts herself. In other cases, smelling salts or a 
handkerchief or the palm of the hand moistened with 
ammonia or other stimulant may be held near the face, 
care being taken that none drops in the eyes and that 
it is not held too close to the face, as it may cause 
violent irritation of the air passages. The head and 
face may also be bathed with an alcoholic solution, 
such as camphor, bay rum, etc. 

Friction can also be supplied to the limbs. Dash- 



258 GOOD HEALTH 

ing water in the face and other rough methods are 
to be deprecated, for it must be remembered that, as 
a rule, nature is fully able to deal with this situation. 
Little aid is required beyond placing the person af- 
fected in a proper position with free air and the re- 
lease from tight clothing. 

In some cases, probably where heart disease exists, 
it will be necessary to resort to more active measures. 
If the syncope continues with no signs of returning 
consciousness, stimulants may be injected into the 
rectum with the ordinary syringe in the manner re- 
ferred to in shock. A mustard plaster may be applied 
over the heart for a short time and friction of the 
limbs may be employed, and in some extreme cases, 
artificial respiration may be required. (See Instruc- 
tions for Resuscitation.) 

After recovery from fainting a person should be 
kept quiet until the action of the heart and circulation 
are properly strengthened. 

Shock and syncope are somewhat similar and may 
be due to the same causes. Shock usually follows 
severe injuries, while fainting may be due to some 
trivial cause. It should be remembered that in shock 
the patient is more or less conscious, while in fainting 
or syncope the patient is unconscious. The history of 
the case goes far to establish the diagnosis. 

APOPLEXY OR STROKE OF PARALYSIS 

Apoplexy is a sudden loss of consciousness asso- 
ciated with paralysis due to the failure of a portion of 
the brain to perform its function as a result of hem- 



PROMPT AID TO THE INJURED 259 

orrhage from a diseased cerebral vessel. The hemor- 
rhage occurs on one side of the brain and the paralysis 
takes place on the opposite side of the body for the 
reason that the nerves coming from the brain cross 
from one side to the other. This has been referred to 
in a previous chapter. 

Apoplexy usually affects persons somewhat advanced 
in years, and, as a rule, is not preceded by any warn- 
ing. The attacks not infrequently follow a hearty 
meal. If unconsciousness does not occur at once, it 
does so very shortly afterwards, and the patient can- 
not be aroused. The face becomes reddened and 
congested; the respiration is slow, labored and snor- 
ing or stertorous, the cheeks being puffed out during 
respiration; convulsions may occur. The important 
diagnostic sign is paralysis usually of one side of the 
body. 

Treatment, — The principal object of treatment is to 
arrest further hemorrhage from the brain, conse- 
quently the head should be slightly elevated and 
cracked ice or some other form of cold applied. The 
clothing, particularly about the neck and waist, should 
be loosened. Internal stimvilants^ which tend to in- 
crease the hemorrhage, must not he used. If possible, 
warmth should be applied to the extremities. The 
further treatment must be indicated by the medical 
attendant. 

Apoplexy must be distinguished from fainting and 
intoxication. In fainting the face is pale, the pulse 
weak and the respiration shallow or apparently sus- 
pended ; the attack is usually of short duration. In 



26o GOOD HEALTH 

apoplexy the face is congested, the breathing is noisy 
or snoring, and paralysis of one side of the body is 
usually noticeable. In intoxication, the subject can 
usually be roused, paralysis is not present and vom- 
iting commonly occurs; the odor of alcohol is gener- 
ally present. The last, however, may also be pres- 
ent in apoplexy, for the attack may be associated with 
excessive drinking. This must be carefully considered 
for apoplexy is not infrequently mistaken for intoxi- 
cation. 

EPILEPSY 

Epilepsy is an affection of the brain which at vari- 
able intervals gives rise to an attack characterized by 
convulsive movements and unconsciousness. Subjects 
of this disease are usually warned of the approach of 
paroxysms; the premonitions, however, are as a rule 
of short duration. The person affected may utter a 
sharp piercing cry and fall to the ground in a helpless 
and unconscious condition. He is often seriously in- 
jured in this way. At first there is more or less rigid- 
ity of the muscles; this is quickly succeeded by con- 
vulsive movements ; the eyes are usually opened and 
turned upwards, the face becomes livid and congested ; 
the jaws are brought together with considerable force 
and the tongue is often badly wounded by the teeth. 
There is also considerable foaming and frothing at the 
mouth. The paroxysm lasts but a few minutes and 
consciousness gradually returns, the patient being in 
a stupid and drowsy condition with headache for some 
time afterwards. 

Treatment. — The patient should be placed in the 



PROMPT AID TO THE INJURED 261 

recumbent position (on the back), all clothing being 
loosened, particularly about the neck. A handkerchief 
knot, a piece of wood or some other suitable article, 
which will prevent injury to the tongue, should be 
placed between the teeth, although not allowed to drop 
into the mouth. After the fit is over no further treat- 
ment is usually required, although it should be re- 
membered that sometimes a temporary aberration of 
mind may follow. If this occurs, the patient should 
be watched for some time after the seizure. 

HYSTERIA 

Hysteria is a functional affection of the mind and 
nervous system, usually affecting women. It is char- 
acterized by temporary loss of will power and with 
considerable emotional display; the affected person 
laughs and sobs immoderately without regard to sur- 
roundings. 

The importance of giving this condition special con- 
sideration lies in the fact that it sometimes assumes a 
form which may be mistaken for syncope, shock or 
epilepsy, according to the manifestations of the patient. 
A case of hysteria may be distinguished from fainting 
as follows: In fainting the face and extremities are 
cold and the pulse is very weak and apparently lost, 
whereas in hysteria the face and extremities are warm 
and the pulse is normal. An effort to open the eye- 
lids in hysteria meets with opposition, but with none 
in fainting. In hysteria which simulates epilepsy, the 
tongue is not injured, and if the patient falls to the 
ground a suitable place is selected for this purpose to 



1262 GOOD HEALTH 

avoid injury. There is no frothing at the mouth un- 
less soap or other agents are used for this purpose. 

Treatment. — The most effective treatment for hys- 
teria is to let the person alone ; to sym.pathize usually 
prolongs the attack and does no good. Firmness on 
the part of the attendant, with an intimation that the 
condition is fully understood is usually all that is re- 
quired. It is a common practice to douche a hyster- 
ical patient with cold water ; there is very little excuse 
for such rough treatment, particularly as the person 
affected is apt to be a delicate woman. 

HEAT-STROKE, SUN-STROKE, INSOLATION, SUN- 
FEVER, FEVER HEAT 

The term heat-stroke is now used to denote the 
various manifestations which sometimes follow ex- 
posure to intense solar or artificial heat. Those who 
are employed in hot and close apartments where the 
air is impure, as in mines and in fire-rooms of steam- 
ers, are particularly liable to be affected by heat-stroke. 

It is a fact worthy of notice that those who gen- 
erally suffer from this malady are either addicted to 
the excessive use of stimulants or are in a weak and 
debilitated condition. 

Heat-stroke does not always develop abruptly, nor 
does it generally occur at the beginning of the heated 
term, but usually after the hot weather has persisted 
for two or three days. There are certain symptoms 
which indicate the approach of this affection and 
should be recognized as a warning; viz., an irritable 
and depressed condition, headache, congestion of the 



PROMPT AID TO THE INJURED 263 

eyes, flushing of the face, dryness of the skin and 
sometimes nausea. Unless the person affected seeks 
relief, the symptoms just enumerated may be followed 
by more serious ones, as delirium, convulsions and 
unconsciousness. In this connection the temperature 
of the body has been known to rise to 108° to 110° F. 
— normal temperature being 98.6°. The pupils are 
generally dilated, although sometimes contracted. The 
pulse at first is strong and rapid, but subsequently 
becomes weak. Death may occur suddenly in con- 
sequence of the action of the high temperature upon 
the nerve centers, or at a later period as the result 
of exhaustion. A large percentage of those who re- 
cover from the immediate effect of heat-stroke sub- 
sequently suffer from some temporary or permanent 
affection of the nervous system. 

Treatment. — There are two important indications 
for treatment: reduction of temperature and the use 
of stimulants. The use of cold is regarded as the 
best method of meeting the first indication, and the 
manner of its application depends upon the facilities 
at hand. The patient should be removed to a cooler 
spot if possible, or at least where shade can be se- 
cured, or if a person succumbs in a place where the 
ventilation is defective, in addition to the heat, he 
should be carried into the fresh air. The treatment 
should be begun at once. Eft'orts are often made to 
take the patient home which may involve considerable 
time and cause still further exhaustion. 

The clothing about the neck and body must either 
be removed or loosened. Cold is particularly indi- 



264 GOOD HEALTH 

cated in cases where the body is greatly heated and 
delirium and convulsive movements are present. This 
means of reducing the temperature may be applied by 
cracked ice about the head and spine, or by cold water 
by means of a sponge, sprinkling pot, or hose, the 
pressure being carefully regulated. However, a good 
plan is to remove the clothing and sponge the body 
with cold water at frequent intervals. In extreme 
cases it may be necessary to wrap the patient in sheets 
wet with cold water. The sheets are to be kept wet 
by frequently pouring water over them while on the 
body until consciousness returns or there is evidence 
of marked fall of temperature. After the cold has 
been discontinued, should serious symptoms such as 
unconsciousness or a return of the previous high tem- 
perature occur, the cold applications should be re- 
peated. 

If there is evidence of great depression, stimulants 
must be used while the cold is being applied. 

There are some cases of heat-stroke where stimti- 
lants alone are indicated, as when the signs of a high 
fever are absent, great depression is present, the skin 
is cold and blue and the pulse is weak. In these cases 
in addition to the use of judicious internal stimula- 
tion, the application of mustard over the heart and to 
the calves of the legs is indicated. 

The treatment of simple heat exhaustion consists in 
rest, bathing the face with an alcoholic solution and 
the judicious internal use of a stimulant. 



PROMPT AID TO THE INJURED 265 

ASPHYXIATION— SUFFOCATION 

Asphyxiation is a condition of unconsciousness due 
to a largely diminished amount of oxygen in the blood 
resulting from an obstruction in the passage of air 
to the lungs, or to the presence of poisonous gases 
which render the air unfit for respiration. Among 
the ordinary causes of suffocation are drowning, hang- 
ing, obstruction in the respiratory tract, either by the 
lodgment of foreign bodies or by certain maladies 
affecting this part, as diphtheria, and the inhalation of 
the fumes of charcoal or coke and the carbonic acid 
gas contained in empty wells, caves, beer vats and 
mines. In mines it is known as "choke damp." Coal 
gas from stoves and illuminating and sewer gases are 
also a frequent cause of suffocation. The appearance 
of a person suffering from asphyxia is characteristic. 
The face is of a dusky or purplish hue, owing to defi- 
cient oxygenation of the blood, and swollen. The res- 
piration is extremely labored and associated with con- 
vulsive movements and delirium. If relief is not 
promptly at hand, these symptoms are rapidly fol- 
lowed by unconsciousness and death. 

Treatment. — The treatment of asphyxiation consists 
in removing the cause in order that the lungs may 
be supplied with the proper amount of pure air, 
and restoring the different functions to their nor- 
mal condition by stimulants and artificial respira- 
tion. 

Precautions. — In rescuing a person from an empty 
well, for instance, care should be taken that the mouth 



266 GOOD HEALTH 

and nose of the person making the descent are pro- 
tected by holding against them a cloth saturated with 
water or vinegar and water. A rope should also be 
tied around the waist of the rescuer by which he 
can be brought rapidly to the open air. Matches 
should not be ignited while in the well, nor should 
any artificial light be carried down, for while car- 
bonic acid gas, which constitutes the bulk of poison- 
ous gases in these receptacles, does not support 
combustion other gases may be present which are 
ignitable and a serious explosion would probably 
follow. 

Sewer gases are often inflammable and illuminating 
gases always so. A light should never be taken into a 
cellar or any apartment where gas has escaped until 
the room has been thoroughly ventilated by open doors 
and windows. 

It is often necessary to enter empty wells and cess- 
pools in order to examine or clean them. The car- 
bonic acid gas which they contain and which is 
heavier than air and consequently settles to the bot- 
tom, should be stirred up and removed previous to 
making any descent for examination. This may be 
done by free ventilation, by pouring into the well large 
quantities of water or, even better, lime water, by 
lowering and quickly withdrawing an opened um- 
brella, or throwing down lighted papers and straw. 
Should the last be done, care should be taken not to 
remain near the opening as inflammable gases may be 
present. A gun may be discharged into these recep- 
tacles for this purpose. 



PROMPT AID TO THE INJURED 267 

Drowning 

The asphyxiation or suffocation that follows sub- 
mersion is due to the fact that the air is prevented 
from reaching the lungs. More or less water is found 
in the air passages, but not in such quantities as is 
generally supposed. In some cases very little, if any, 
water reaches these organs on account of the rapid 
closure of the epiglottis, the covering of the wind- 
pipe. Water also enters the stomach, and considerable 
is found mixed with the mucus in the throat. Death 
is usually the result of suffocation. However, in some 
cases it may be due to sudden heart failure before 
the person sinks. When such is the case, the face of 
the person is pale and flabby, and very little water and 
mucus is found in the respiratory tract. There is a 
better chance of resuscitating a person who sinks as 
the result of syncope than when suffocated, as the 
demand for oxygen in the former is less than when 
asphyxiated by submersion. 

Persons who are submerged for four or five min- 
utes or more, are not usually restored to life, although 
numerous cases are recorded where resuscitation was 
effected after an interval of twenty minutes or so. 
In such cases it is supposed that syncope occurred, 
or on account of the existing excitement, an error was 
made in calculating the actual time of submersion. 
The action of the heart usually continues for some 
time after respiration ceases. 

Treatment, — This consists first in reestablishing 
respiration, then stimulating the action of the heart 



268 GOOD HEALTH 

and circulation by stimulants, warmth, friction, etc. 
When a person has been under water but a very short 
time, simple means may restore respiration, and the 
following procedure should be tried : 

The water, sand and mucus should first be quickly 
removed from the mouth and nose. The attendant 
should then carry his finger to the back or base of 
the patient's tongue, which must be pulled forward 
to permit the water and mucus in the throat and 
respiratory tract to escape, and also to favor the en- 
trance of air into the lungs. While this is being done, 
the patient should be turned on his side, left if pos- 
sible, face downward to favor the escape of water 
from the stomach and air passages. He should 
then again be turned on his back, while the hands 
of the attendant are placed on the abdomen and 
pressure directed upward and inward toward the dia- 
phragm. This movement tends to stimulate respira- 
tion and should be repeated two or three times at 
intervals of two or three seconds. The mouth in 
the meantime should be kept open by a cork or piece 
of wood, or a knot tied in a handkerchief, etc., in 
order that the passage of air in the lungs should 
not be interfered with. Smelling salts, ammonia or 
two or three drops of nitrate of amyl placed on 
a handkerchief or on the attendant's hand may be 
administered by inhalation, or the nose may be 
tickled with a feather or straw. When breathing 
commences and consciousness returns, the patient 
should be carefully divested of all wet clothing — if 
necessary the clothing should be cut to avoid delay — 



PROMPT AID TO THE INJURED 269 

well rubbed, and wrapped in warm covering, and stim- 
ulants given in the manner already described. (See 
Shock.) 

If the simple measures just described are not 
successful after a brief trial, artificial respiration 
should be resorted to. Before this is begun, the pa- 
tient should be stripped to the waist or at least cloth- 
ing around the waist should be loosened, so that the 
necessary manipulations may not be hindered. It must 
be remembered that in artificial respiration, the normal 
respiratory action of about eighteen respirations per 
minute should not be exceeded. This is often over- 
looked. (See Instructions for Resuscitation.) 

BURNS AND SCALDS 
Burns 

These injuries are caused by the action upon the 
tissues of some form of dry heat or by a chemical 
agent. For practical purposes burns are divided into 
three degrees: (i) simple redness of the skin; (2) 
vesication or the formation of blisters; (3) more or 
less destruction or charring of the skin and deeper 
structures. 

Burns of the first and second degree are usually 
unattended by serious consequences. However, it is 
said that when they involve more than one-half of 
the body, the result is generally fatal. 

Burns of the third degree are dangerous accord- 
ing to their situation, extent and complications. When 
the chest or abdominal walls are involved, the condi- 
tion may prove very serious. 



270 GOOD HEALTH 

Death following burns is usually the result of shock 
during the first twenty- four hours, internal inflam- 
mation, ulcers or hemorrhage, blood poisoning, tet- 
anus (lockjaw), or exhaustion. 

The temperature of the body falls immediately 
after a severe burn occurs; this is temporary and is 
soon followed by fever. 

In burns of the third degree which heal by granu- 
lation, or the formation of new tissues, the contrac- 
tion of the scar and the subsequent deformity are 
marked. 

Treatment, — The treatment of burns is divided into 
local and constitutional. 

The local treatment depends upon the degree to 
which it belongs. In burns of the first degree, rem- 
edies which are soothing and protective should be 
applied. Among those which generally can be ob- 
tained at once, are bicarbonate of soda (common bak- 
ing soda, not washing soda), starch, chalk, magnesia, 
charcoal and boric acid powder. One of these may be 
freely dusted over the surface. Lime water may also 
be used. An application commonly used for this pur- 
pose and known as ''Carron oiF' (first used in the 
Carron Mines), is composed of equal parts of lime 
water and linseed oil, and is very soothing and excel- 
lent for this class of burns. VaseHne or olive oil may 
also be used. These should be freely applied to the 
surface and covered with an antiseptic gauze or a piece 
of clean linen or muslin, and retained by a bandage. 

In burns of the second degree, the bHsters require 
special treatment. If the clothing is attached to the 



PROMPT AID TO THE INJURED 271 

burn, it should never be forcibly removed, but care- 
fully cut off with scissors as close to the burn as pos- 
sible. The small piece adhering to the skin may be 
washed away with warm water, or softened with oil 
and detached later. If the blisters are large they 
should be pricked at their lowest point with a large 
needle, the point of which has been held in a flame 
for a few seconds to destroy any source of infection 
which may be present. The cuticle over the blister 
should not be removed, for it acts as a protection to 
the raw surface. The oily substances recommended 
for burns of the first degree may then be carefully ap- 
plied. 

In burns of the third degree where there is destruc- 
tion of tissue, more or less sloughing will subsequently 
occur with possibly some serious complications. Un- 
der these conditions it is extremely important that the 
patient should be placed in the hands of a physician 
as promptly as possible. Therefore, emergency dress- 
ing need be only some simple covering as a temporary 
means of protection, for it will be necessary sooner or 
later to remove dead tissue and carry out various 
means of treatment applicable to this condition. 

In burns caused by acids, generally sulphuric, nitric 
and muriatic acids, water should not be applied, for 
when combined with acids, an elevation of the tem- 
perature of the mixed fluids immediately follows. The 
proper remedy should be the application of an alkaline 
powder — bicarbonate of soda, magnesia, chalk or lime ; 
the last may be scraped off whitewashed walls. These 
agents neutralize the acid; they should be left on the 



2^2 GOOD HEALTH 

surface for a few minutes and then washed off. Di- 
lute ammonia water may also be used. 

If an acid is splashed into the eye, lime water, soda 
or magnesia in solution should be applied at once. 
Burns of the mouth and the throat from the same 
cause should also be treated by the free use of the al- 
kalies already mentioned. 

Burns caused by caustic alkalies — caustic soda, pot- 
ash, lime, ammonia, quicklime and lye — should be 
treated by acid solutions, such as diluted vinegar, 
lemon juice, hard cider, etc. 

After the acid or alkali causing the burn has been 
neutralized, the oily substances already referred to 
should be applied as in ordinary burns. 

Some of the severest forms of burns follow catch- 
ing fire of some portion of the wearing apparel. A 
person whose clothes are afire should be at once en- 
veloped in a blanket, mat, piece of carpet, the coat of 
someone present, or whatever may be at hand for this 
purpose, or the victim may be rolled over the floor 
to extinguish the flames. Water should be used freely, 
and the clothing carefully examined to ascertain if the 
Hre has been entirely extinguished. The burned sur- 
face should then receive proper attention. 

Scalds 

These are injuries produced by the application of 
moist heat, boiling water, steam, etc. Children often 
suffer from them as the result of pulling over recep- 
tacles containing hot water, coffee and tea. Scalds 
should be treated as burns of the first and second de- 



PROMPT AID TO THE INJURED 2yi 

grees. The constitutional treatment of burns and 
scalds, as far as prompt aid is concerned, deals chiefly 
with shock which has already been described. 

FROST-BITE 

Prolonged exposure of the body to a very low tem- 
perature results in a general or local loss of vitality. 
If the air is still, it is favorable to the one exposed, 
but when the wind is blowing, the warm air close to 
the surface of the body is rapidly removed and the 
destructive effect of the cold is considerably increased. 
An exposure of one or two hours may be followed by 
a fatal result. Persons succumbing to extreme cold 
are soon overcome by an irresistible sense of drowsi- 
ness and desire to sleep. To yield to the inclination is 
usually fatal. This disposition to stupor is due to the 
great diminution in the blood supply to the surface of 
the body and consequent congestion of internal organs. 
In this condition the brain is unable to perform its 
function and drowsiness follows. 

When a person becomes frozen, the limbs become 
stiff and the skin turns bluish or purplish and then 
white. These changes in the color of the skin denote 
that the circulation of the surface of the body is pro- 
foundly interfered with. This is often followed by 
excessive reaction, inflammation and gangrene. 

Treatment. — A frozen person should not be taken 
into a warm room, or have warmth applied to the 
body. An abrupt change in temperature would prob- 
ably prove fatal. The temperature of the body must 
be gradually raised; the patient should be taken to a 



274 GOOD HEALTH 

cool apartment, the clothing removed, and the body 
rubbed with snow or cold water. After a short time, 
if consciousness returns and the limbs lose their rig- 
idity, friction with a piece of flannel or, still better, 
the hand, can be substituted for the cold applications. 
A little later the continuous rubbing should be discon- 
tinued and occasional friction resorted to. These 
measures must be pursued very gently, as rough ma- 
nipulation may destroy the skin. In some cases ar- 
tificial respiration may be called for. (See Instruc- 
tions for Resuscitation.) 

Stimulants should be carefully administered. If the 
patient cannot swallow, they may be given by the rec- 
tum, as in shock. Nourishment in the form of beef 
tea or milk should be given as soon as the patient can 
take it. The surface of the body should be carefully 
protected and not subjected to heat, as some time will 
elapse before the circulation regains its equilibrium. 

WOUNDS 

A wound is an injury of the outer tissues of the- 
body associated with more or less division of the skin 
and soft structures, and produced by a mechanical 
agent. Wounds are classified as follows : incised, lac- 
erated, punctured, poisoned and contused. 

Incised wounds are made by sharp cutting instru- 
ments, as knives and razors. The edges of a wound, 
when applied to each other, fit accurately and complete- 
ly close the opening. Hemorrhage constitutes one of 
the principal dangers of this form of injury, for the 
blood-vessels are evenly divided, and the openings are 



PROMPT AID TO THE INJURED 275 

not so quickly closed as when the wound is jagged. 

Lacerated wounds are made by stones, clubs or im- 
plements which are rough and blunt and produce 
more or less destruction of tissues about the wound,, 
the edges of which are ragged and torn. Consider- 
able local inflammation and constitutional disturbance 
often follow lacerated wounds. 

Punctured wounds are inflicted by bayonets, dag- 
gers, swords, arrows, or other weapons which are sharp 
and narrow-pointed. Snake bite is also a form of 
punctured wound. Although the openings are quite 
small, these wounds usually penetrate to a considerable 
depth and may injure important blood-vessels and vital 
organs, or may introduce infectious matter. 

Gunshot wounds are caused by bullets, cannon balls, 
and the like. The danger resulting from gunshot 
wounds depends upon the hemorrhage, particularly 
that occurring internally, the injury to organs in- 
volved, the amount of tissue destroyed, the shock and 
the subsequent inflammation, suppuration and blood- 
poisoning. 

Foreign substances, such as bits of clothing, are 
often carried into the body by bullets and other mis- 
siles, frequently beyond observation, and constitute 
an additional element of danger. The point of en- 
trance of a ball is apt to be smaller than the exit, as 
a result of diminished velocity. 

Poisoned wounds are caused by the introduction into 
the tissues through the skin of some form of virus, as 
that of a snake bite. These wounds are usually punc- 
tured, although they may be lacerated, as in the bite of 



2.7(i GOOD HEALTH 

a rabid dog. Contrary to the general belief, the bite of 
the venomous snakes in this country, such as the rat- 
tlesnake, moccasin, copperhead, and one or two oth- 
ers, is not generally fatal, and although the virus acts 
with great rapidity and intensity, only about one out 
of every seven or eight bitten dies from this cause. 
Snakes are most dangerous in warm weather and 
after fasting. A person who has been bitten by a poi- 
sonous serpent becomes faint and depressed within a 
few minutes, the pulse feeble and the pupils dilated. 
More or less delirium occurs and the extremities be- 
come cold and clammy. Considerable swelling and 
discoloration usually take place about the wound; in- 
tense pain is also present. In fatal cases, death may 
-occur within a few hours. 

A contused wound is one in which the division of 
the soft structures is associated with more or less 
contusion or bruising at the site of injury. 

Healing of Wounds. — Although the method of heal- 
ing of wounds is divided by physicians into many va- 
rieties, it wall be sufficient in this description to rec- 
ognize but two of them: immediate union, and union 
by granulation. 

Immediate union usually occurs when the edges of 
the wound fit accurately and are not displaced by hem- 
'Orrhage or improper dressing, when foreign bodies 
are removed, the wound properly cleaned and the 
injured part kept immobile. It is always desirable to 
obtain this result, for, aside from other advantages, it 
prevents disfiguring scars. 

Wounds associated with considerable destruction of 



PROMPT AID TO THE INJURED 277- 

tissue, as lacerated wounds and burns of the third de- 
gree, heal by granulation. The first step in this form 
of repair is the removal by nature of the destroyed 
and useless tissues about the wound by the process, 
known as suppuration and sloughing. After the wound 
is thus cleared, granulation, or filling in, takes place. 
After granulation has entirely filled the wound, the 
upper surface becomes smooth, shining and red, which 
appearance is the result of the process of cicatrization, 
and is known as a scar, or cicatrix. The glands of the 
destroyed skin are not reproduced, and hair does not 
grow from the new formation. 

The proper healing of \younds is commonly inter- 
fered with by severe local inflammation and constitu- 
tional disturbances due to the presence of germs or 
bacteria which infect the wound. This condition has 
developed within recent years a method of treatment, 
the purpose of which is to retard or destroy the growth 
of these microscopic organisms, a most important con- 
sideration. Modern methods have clearly demon- 
strated the inestimable value of cleanliness in the treat- 
ment of wounds. 

Treatment. — The treatment of a wound consists 
of the following procedure: arrest of hemorrhage, ex- 
amination of the wound, the removal of foreign mat- 
ter, dressing, support and protection of the injured 
part and rest. 

The variety of hemorrhage should be determined^ 
whether arterial, venous or capillary, and arrested in 
the manner already described. 

A wound should be examined as to its variety,. 



^278 GOOD HEALTH 

whether incised, lacerated, etc., and also as to the 
structures involved. A careful search should be made 
for foreign bodies, which if allowed to remain would 
interfere with the proper healing of the part. Pieces 
of clothing, splinters, etc., should be picked out with 
clean forceps or fingers, and tincture of iodin should 
be appHed to the surface of the open wound by a 
pledget of clean cotton or some other light material 
which is handy. The tincture of iodin is now used as 
a quick, safe and effective means of destroying bac- 
teria or germ^ which may be on the surface of a 
wound and which cause infection and interfere with 
the proper healing of the part. This has already been 
referred to. 

Further treatment in the absence of the surgeon de- 
pends upon the character of the wound. H incised, 
the edges should be brought closely together, and re- 
tained in apposition by applying over the opening a 
compress preferably made of antiseptic gauze, or a 
clean piece of muslin, and then holding the parts to- 
gether by strips of adhesive plaster. This is a sub- 
stitute for the proper closing of the wound by the use 
of suture or stitches, which hold the edges closely to- 
gether and favor accurate union. The strips of ad- 
hesive plaster should not entirely surround the limb, 
as they would interfere with the circulation. They 
should be applied at intervals to allow the free exit of 
any matter or pus which may form at the site of in- 
jury. One end of the strip should be placed on one 
side of the wound, the edges of which are held closely 
together, and the remainder of the strip should be car- 



PROMPT AID TO THE INJURED 279 

ried over the edges and made fast. On removing 
adhesive plaster, both ends of the strip should be 
loosened at the same time, and carried from the skin 
toward the wound, thereby preventing the separa- 
tion of its edges. The compress should be held in place 
by a bandage of some kind which keeps the edges of 
the wound together. 

Lacerated wounds which are associated with more 
or less destruction and loss of tissue heal by granu- 
lation; consequently no effort need be made to bring 
the edges too closely together, which might subse- 
quently interfere with the proper escape of discharges. 
Otherwise, the same kind of dressing should be applied 
as in incised wounds. 

The immediate local treatment of a punctured 
wound is very simple, and consists in applying a cov- 
ering over the puncture. The result of such a wound 
is extremely uncertain; it depends upon the imple- 
ment causing the injury and should be carefully 
watched for any subsequent evidence of inflammation 
or infection. 

In gunshot wounds, the first effort should be to 
arrest the hemorrhage, protect the wound with dress- 
ing and treat the accompanying shock. All foreign 
bodies which are about the surface of the wound and 
are not retained by blood clots can be removed. Xo 
exploration for the bullet should be made except by 
a surgeon. The wound should, if possible, be dressed 
antiseptically and splints applied to prevent movement 
of the limb. The patient should be conveyed at once to 
a place where he can secure the proper surgical treat- 



28o GOOD HEALTH 

ment, for wounds of this character are frequently as- 
sociated with tetanus or lockjaw. 

When a person has been bitten by a snake, he should 
immediately endeavor to remove the poison by suction. 
If the wound be inaccessible to the patient himself, 
this may be done by someone else willing to assume 
the risk. It is believed that the venom has no effect 
upon the mucous membrane of the mouth unless cuts 
or abrasions are present. Cuts or abrasions of the lips 
may admit the poison. H a leg or arm is bitten, in ad- 
dition to suction, the part should be immediately sur- 
rounded by a tight bandage between the wound and 
the heart. This is an effort to prevent or retard the 
absorption of the poison into the system. It should 
not be forgotten that the bandage should be occasion- 
ally loosened to prevent any serious interference with 
the general circulation of the part. Cauterization 
would be of no value in this variety of poisoned wound. 
The depression that follows the absorption of the 
poison demands the use of stimulants — whisky or 
brandy, for instance. It is not necessary or proper, 
however, that the patient should be made intoxicated. 
If necessary, stimulants, properly diluted, may be 
given by the rectum, always in larger doses than 
those given by mouth. 

The prompt treatment of a wound caused by the bite 
of a dog supposed to be suffering from rabies, or hy- 
drophobia, is substantially the same as in snake bites, 
although if suction is impracticable by the person 
bitten, the wound may be cauterized by heating the 
tlade of a pen-knife, button-hook or piece of wire, red 



PROMPT AID TO THE INJURED 281 

hot, and applying it to the wounded surface. The poi- 
son introduced does not develop rapidly and the con- 
stitutional symptoms may not appear for weeks ; there- 
fore, stimulants are indicated only when shock is pres- 
ent. The suspected animal should be at once closely 
confined until under professional guidance it is killed 
and specimens secured and forwarded to some labo- 
ratory, where they can be examined to determine 
whether or not rabies exists. The Pasteur treatment 
of this injury, by the injection of the antirabic emul- 
sion, is now regarded as successful, and prompt sci- 
entific procedure fortunately may be carried out with 
little difficulty. 

The wounds caused by tarantulas, centipedes, spi- 
ders, bees, wasps and other insects are very seldom 
dangerous. The local application of dilute ammonia 
or a solution of bicarbonate of soda is regarded as the 
most efifective remedy, and generally relieves the pain 
at once. Wet fresh earth, common salt or a slice of 
an onion may also be employed. Stimulants may be 
indicated in some cases. 

Wounds of the abdominal walls are very dangerous, 
particularly so if the injury extends to the abdominal 
cavity, which is frequently the case. The external 
opening is often sufficiently large to allow the escape 
of the bowels or intestines. If this occurs, the mass 
should be covered with clean cloths wrung out in hot 
water for protection until the physician arrives. Over 
this application should be placed other material, which 
tends to retain the warmth and offers gentle support. 
A wound of the abdominal walls which does not enter 



282 GOOD HEALTH 

the cavity, although in some instances dangerous, 
should be treated as an ordinary wound. The shock 
which accompanies abdominal wounds must receive 
appropriate treatment. 

Wounds of the thorax or chest are often associated 
with injury of the lung. Should this complication ex- 
ist, it can be recognized by pain and irritation, cough- 
ing, difficult breathing, hemoptysis, or spitting of blood, 
and the appearance of blood and mucus in the expec- 
toration. Sometimes air enters the pleural cavity, 
which greatly increases the size of the chest on the 
affected side. 

When this condition is present, the external wound 
should be closed, a compress and bandage firmly ap- 
plied, and the patient placed in a recumbent position. 
If great distress follows, the dressing must be re- 
moved and the patient turned on the side where the 
wound is, thus favoring the escape of accumulated 
blood in the chest. 

Rest is essential in the proper healing of wounds 
and should be insisted upon, particularly if the in- 
jury is of a serious nature. The limbs may be kept 
quiet by the use of splints or slings. 

FRACTURES 

A fracture is a breaking or solution of continuity 
in a bone. While there is an extended classification of 
fractures, it will be sufficient in connection with prompt 
aid work if two kinds are borne in mind : simple and 
compound fractures. 

A simple fracture is one in which the bone is broken 



PROMPT AID TO THE INJURED 283 

into two fragments, the ends of which do not pro- 
trude through a puncture of the skin or seriously in- 
jure adjacent structures. 

In a compound fracture, the broken bone penetrates 
the soft tissue and communicates with the air. 

A fracture is either complete or incomplete. A 
complete fracture is the usual variety, and involves 
the entire separation or loss of continuity of a bone. 
An incomplete fracture not infrequently occurs in chil- 
dren, owing to the elasticity of bone in early life, and 
has received the name of partial or ''greenstick" frac- 
ture. 

The signs and symptoms of a fracture are deformity, 
abnormal mobility at the point of fracture, bony 
crepitus, or grating, when the divided parts are rubbed 
together, pain, loss of function and subsequent swell- 
ing and discoloration. Surgeons now employ the x- 
ray as a means of diagnosis in these cases. 

The repair, union, or knitting of the bone is begun 
by nature soon after the fracture and is accomplished 
by a substance formed at the seat of injury known 
as callus or cement, which is thrown around and be- 
tween the ends of the broken bone. Although soft at 
first, this material gradually hardens and firmly unites 
the bones. 

Treatment. — The object of a surgeon in treating a 
fracture is to assist nature. He first carefully reduces 
the fracture or sets the bone ; that is, he endeavors to 
bring the broken ends in apposition or directly against 
each other in proper place, and to retain them in po- 
sition for a certain length of time by splints or some 



284 GOOD HEALTH 

other form of support until the callus has performed 
its function. 

Although it is best that a fracture should be re- 
duced and the proper dressing applied as quickly as 
possible after the accident, it should be remembered 
that the union of the fragments does not begin at 
once, and that a fracture inay remain some days before 
being reduced and still be followed by excellent re- 
sults. It should also be remembered that a frequent 
cause of compound fracture is unskillful manipulation. 

When a person not a doctor of medicine is called 
upon to give prompt aid where a fracture is suspected, 
his duty consists in protecting and making immovable 
the injured part, and carefully conveying the patient 
to the hospital or some place where he can receive the 
attention of a physician. 

An injured person suspected of having a fracture 
should not be moved from the position in which he is 
found until an examination is made as to the charac- 
ter of the injury. A violation of this rule is often 
the cause of compound fractures. 

A brief account of the manner in which the injury 
was received should be obtained from the patient or a 
bystander. An examination should then be made. If 
the injury is about the ankle or wrist it can be easily 
exposed. However, if closer to the body, the cloth- 
ing should be cut away and not removed in the ordi- 
nary manner which would be likely to disturb the 
fragments of the bone. If practicable the garments 
may be ripped at the seams. 

After the seat of injury has been examined and the 



PROMPT AID TO THE INJURED 285 

presence of the fracture suspected, the clothing previ- 
ously turned aside can now be replaced and wrapped 
around the part, thus affording considerable protection 
to it. The splint should then be adjusted and the pa- 
tient removed to a place where he can have the proper 
medical treatment. 

Splints can be made of any material which is capa- 
ble of rendering the part practically immovable with- 
out injuring the soft structures to which they are ap- 
plied. They should be long enough to extend some 
distance above and below the injury, generally includ- 
ing the nearest joint, and at times, two or three joints, 
as in a fracture of the thigh. Their diameter should 
exceed that of the limb to which they are applied, al- 
though this is not altogether necessary, as a cane, um- 
brella or sword makes a fair support. Two splints 
are generally used, one for the inner and the other 
for the outer side of the limb. Splints should also 
be padded on the side next to the skin with some soft 
material so as to prevent undue pressure and injury. 
After a splint has been fitted to the limb it should be 
retained by bandages of some kind. The latter, how- 
ever, should not be placed next to the skin at the 
point of fracture, nor should they be drawn so tight 
around the splints as to increase the suffering of the 
patient. 

Although thin wooden boards make very valuable 
splints in emergency, for they are light and easily 
formed to suit special cases, other material may be em- 
ployed with good results. Among those which can be 
used in emergencies are shingles, lathes, fence-boards, 



2^ GOOD HEALTH 

portions of cigar boxes, barrel staves, bark of trees 
or even branches of trees, binders' board, book covers, 
leather and innumerable other articles. More re- 
cently, heavy wire netting is supplied for this purpose ; 
even a number of newspapers tightly folded together 
may be used as a splint. A pillow or an article of 
clothing properly folded may be used as a splint and 
pad combined. 

For padding, cotton or any soft substance may be 
used, such as articles of clothing, furniture, stuf- 
fing, straw, hay, etc. Bandages for retaining the splint 
may be purchased in any drugstore. Handkerchiefs, 
neckties, suspenders, strips of clothing and straps may 
also be used. 

The danger which follows a want of knowledge on 
this point relates chiefly to the fact that a fracture may 
be transformed from a simple to a compound one by 
forcing the ends of the bone through the skin or by 
injuring blood-vessels, nerves and other tissues. 

The danger of a compound fracture is very great, 
for it not only diminishes the chance of securing a 
good bone union, but it is apt to cause blood poison- 
ing and sloughing of tissue, not infrequently with 
fatal results. 

With this point well in mind, the need of fixation 
at the point of fracture and the importance of con- 
fining nearby joints, in order that they may not disturb 
the ends of the bone, is apparent. If these principles 
are firmly adhered to, those who are called upon to 
render prompt aid will be able to perform valuable 
service in this emergency. 



PROMPT AID TO THE INJURED 287 

DISLOCATIONS 

A dislocation or luxation is a forcible displacement 
of one articular surface of a bone from another, and 
may be the result of direct violence or muscular con- 
traction. More or less rupture of the ligaments about 
the joints always takes place. The chief signs of a 
dislocation are deformity and loss of function of the 
joint. The mobility of the part is greatly diminished, 
while in fractures a false point of motion occurs as 
the shaft of the bone is usually injured. 

The reduction of a dislocation requires considerable 
technical skill, and should be performed only by a 
physician. For this reason it is necessary to remove 
the patient as promptly as possible to a place where 
proper treatment can be obtained. 

SPRAINS 

A sprain is a wrenching or twisting of a joint, as- 
sociated with considerable stretching or tearing of the 
tendons and ligaments in the vicinity. Sprains occur 
most frequently at the ankle or wrist. Pronounced 
swelling and pain rapidly ensue. Fractures at or near 
the joints are very frequently mistaken for sprains. 
In some cases, it is difficult or impossible to decide 
between them ; therefore, the value of an x-ray exami- 
nation is apparent. 

Many so-called sprains are really fractures and are 
improperly treated, with resulting deformities of the 
part. Therefore, one who is not a physician should be 
exceedingly careful in giving an opinion regarding 



288 GOOD HEALTH 

an injury of this kind and should not suggest treat- 
ment. It is very much safer to refer the person in- 
jured to someone who is properly qualified to treat the 
condition. 



INDEX 



Abdominal wounds, 281, 282 
Acid fruit juices, value of, 

113, 114 

Acid solutions for alkaline 
burns, 272 

Acids, burns from, 271, 272 

''Adam's apple," 32 

Aerial infection, 201 

Air, composition of, 62 
for heat stroke, 263 
for suffocation, 265, 266 
importance of fresh, 66, 

133, 134 
impurity of, 64, 135 
pressure of, 68 
purification of, 136 
Air cells, 33, 35 
Air supply, amount of, 134, 
138, 139 
during sleep, 164, 165 
Alcohol, for hemorrhage 

from the mouth, 247 
Alcoholic drinks, 120, 148, 

149 
Alimentary tract, length of, 

36 
Alkalies, burns from, caus- 
tic, 272 
Alkaline powders for acid 
burns, 271, 272 



Alum, for hemorrhage, 247 

Animal bites, treatment for> 
280, 281 

Animal matter in bone, 2 

Anopheles mosquito, 205, 209,. 
210 

Antibodies, 195, 196 

Antiseptics, 235, 237 

Antitoxin, 195-198 

Anus, 44 

Aorta, 23, 24 

Aponeurosis, 17 

Apoplexy, 25, 57, 150 
treatment for, 258-260 

Appendicitis, 44 

Appendix, 44 

Apples, 113 

Arm, bones of, 9, 10 

Arterial blood, 21 

Arterial hemorrhage, treat- 
ment for, 243-245 

Arterial walls, strength of, 

24 
Arteries, elasticity of, 24, 25 
function of, 23 
pulsation of, 24 
structure of, 24 
Artesian wells, 78 
Articulations, movements of,. 
13 



289 



2go 



INDEX 



Artificial respiration, 252-256, 

265, 269 
-Asphyxiation, treatment for, 

265, 266 

Astringents for hemorrhage, 
247, 248 

Atlantic coast mosquito, 211, 

212 

Atmosphere, weight of, 6S 

Atrophy of muscles, 18 

Auricles, 28, 29 

Bacilli, 193 
Eackbone, 6 

Bacteria,^ body resistance to, 
198 

classification of, 193 

destruction of, in blood, 20, 
21, 195 

discovery of, 192, 193 

examination of, 194 

harmless, 198, 199 

in milk, loi 

in water supply, yy^ 81, 84, 
123, 126, 127 

multiplication of, 194 

toxins of, 195, 196 

See also Infection 
Bacteriology, 193 
Ball and socket joint, move- 
ments of, 13 
Banana, 113 
Baseball players, exercise of, 

155 
Bath tubs, 157 
^Baths, effect of, on digestion, 

159, 160 



Baths, frequency of, 157 
temperature of, 158 

Beans, 112 

Beds, 165 

Beef, 108 

Beriberi, 112 

Bicarbonate of soda for 
burns, 270, 271 

Bile, secretion of, 45, 46 

Bladder, 48 

Blisters from burns, 270, 271 

Blood, circulation of, 23, 27 
coagulation of, 21 
color of, 21 
composition of, 19, 20 
functions of, 19 
specific gravity of, 21 

Blood pressure, in arteries, 

24 

in veins, 26 
Blood supply for muscles, 17 
Blood-vessels in skin, 49 
Blue vitriol, 238 
Boiled milk, 102, 103 
Boiled water, S3, 179 

as disinfectant, 232, 235, 
236 
Bone, composition of, 2, 3 

nutrition of, 4 
Bones, arrangement of, in 
skeleton, 5 

fractures of, 282-286 

number of, 5 

shape of, 4, 5 
Boric acid for burns, 270 
Bottled water, 81 
Brain, position of, 6, 53 



INDEX 



291 



Brain, structure of, 53, 55 

weight of, 57 
Brain workers, exercise for, 

154, 155 
Bread, 11 1 
Breakfast, 116, 1 17 
Breast bone, 8 
Broken arch, 12 
Bromin, as deodorant, 2^7 
Bronchi, 2iZ 
Bubonic plague, 202 
Bunions, 162 
Burns, treatment for, 269- 

2:72 
Butter, 100, no 

Callus, formation of, 283, 284 
Calories, 93 
Canals, in bones, 3, 4 
Cancellated tissue of bone, 

2, 3 
Candle lighting, 144 
Capillaries, function of, 25, 

26, 27 
Capillary hemorrhage, 243, 

244, 246 
Carbohydrates, 88 
Carbolic acid, 235 
Carbon dioxid, in air, 62, dz 
Carbonic acid gas in wells, 

2(^ 

Carburetted hydrogen, 65 
Carpets, 176, 177 
Carpus, 10 

See also Wrist 
Carron oil for burns, 270 
Cartilage, 13, 14 



Castor oil, 173 

Cathartics, 173 

Cauterization of animal bites^ 
280, 281 

Cellar, care of, 179 

Central nervous system, func- 
tion of, 52, 59 

Cereals, 91, no 

Cerebellum, 55, 56 

Cerebrospinal nervous sys- 
tem, 52, 53 

Cerebrum, convolutions of,. 

53, 55 

function of, 55 

structure of, 53 
Certified milk, 102 
Cesspools, 128, 129, 180 
Chalk for burns, 270, 271 
Charcoal for burns, 270 
Cheese, 100, loi, no 
Chemical burns, 271, 272 
Chest, 5 

wounds in, 2S2 
Children, as fly catchers, 223^ 
224 

effect of tea and coffee on, 

149 
hygiene instruction to, 185, 

186 
medical inspection of, 181, 
182 
Cholera, bacteria of, 194 
Chyle, formation of, 47 
Circulation of blood, 23, 2y 
effect of exercise on, 150,. 

151 
Clavicle, 8, 9 



292 



INDEX 



Cleanliness in household, 176 
in schools, 185, 186 
in work shops, 187 
Clothing, materials of, 166 
Coagulation of blood, 21 
Coal gas, 142 
Coal stoves, 141, 142 
Cocci, 193 
Coccyx, 1 1 
Coffee drinking, 149 
Cold applications, for apo- 
plexy, 259 
for heat-stroke, 263, 264 
for hemorrhage, 246, 247, 

248, 259 
Cold baths, 158 
Cold weather, clothing in, 

168-170 
Colds, 136, 137, 158, 170 
Colic, 44 
Collar bones, 8 
Colon, 44 

Compact tissue of bone, 2, 3 
Complemental air in lungs, 

36 
Compound fractures, 284,286 
Condensed foods, 99, 100 
Congestion, relief of, 150, 151 
Constipation, causes of, 171, 

172 
treatment for, 172, 173 
Consumption cures, 231 
See also Tuberculosis 
Convalescence, diet during, 

90 
Convulsions. See Apoplexy; 

Epilepsy 



Cooking, methods of, 115, 

116 
Copper, sulphate of, 237, 238 
Copper lime solution, 238, 239 
Corns, 162 

Corpuscles, in blood, 19, 20 
Corrosive sublimate, 235 
Cotton, 166, 168 
Cows, modern care of, 227 
Crabs, 109 
Cramps, 159, 160 
Cranium, 5 
Cream, 100 
Culex pipiens mosquito, 209 

Death, from burns, 270 
from drowning, 267 
from freezing, 273 
from heat-stroke, 263 
from snake-bite, 276 
from suffocation, 265 

Dental clinics, report of, 160 

Deodorants, 180, 235, 22y-23g 

Derma, 49 

Diaphragm, 9 
movements of, 35 

Diet, 90 
for constipation, 172 
for convalescence, 90 
for hard labor, 94 
for sedentary life, 94 
for weight reduction, 119- 

121 
idiosyncrasy in, 98 
reformation of, 148, 149 
standardizing of, 93 

Diet tables, 95-97 



INDEX 



293 



Diffusion of gases, 64, 134 
Digestion, 89 

in small intestine, 42, 43, 46, 

47 
in stomach, 41, 42 

Digestive disturbance during 
bathing, 159, 160 

Digestive fluids, secretion of, 
39, 42, 45, 46, 47 

Diphtheria, antitoxin for, 196 
transmission of, loi, 183, 
185, 203 

Dipped milk, 103 

Disease carriers, 127, 153, 
177, 181, 201, 202, 204 
transmission of. See In- 
fection 

Disinfectants, 235, 22,6 

Dislocations, treatment for, 
287 

Drafts, 136, 137, 165 

Drainage of mosquito breed- 
ing places, 218-220 

Drainage system, construction 
of, 123-125 

Drains, 125, 180 

Dressing for fractures, 283- 
286 
for wounds, 2y^, 279 

Drinking cups, infection by, 
188 

Drowning, treatment for, 
267-269 

Duodenum, 43 

Earth closets, 128 
Earthy matter in bone, 2 



Eggs, food value of, 109, no 
Elasticity of arteries, 24, 25 
Electric fans, ^y^ 191 
Electric heating, 143 
Electric lighting, 146 
Electric shock, treatment for, 

252-256 
Emulsification of fat, 46, 47 
Enamel of teeth, 39 
Endocardium, 31 
Epidermis, 49 
Epiglottis, 32 
Epilepsy, treatment for, 260, 

261 
Epistaxis, 248 
Esophagus, postion of, z^y 40 

structure of, 40 
Excretion, 22 

nerve control of, 59 
Exercise, function of, 150, 

151 
Eyes, examination of, 162 

Fainting, treatment for, 256- 

258 
Fascia, 16 
Fat, 88, 90 

Fat people, treatment for, 119 
Feet, care of, 162, 163, 170 
Femur, 11 

Fermented milk, 104, 105 
Fibula, II 
Filtration of water supply, y6, 

77 
Fire, burns from, 272 
Fire-damp, 65 
Fish, food value of, 108, 109 



294 



INDEX 



Fits. See Epilepsy ; Apo- 
plexy 
Flat bones, 5 
Flat foot, 12 
Fleas, infection by, 202 
Flies, breeding places of, 130, 
132, 178, 221, 222 
extermination of, 223, 224 
hibernation of, 220 
infection by, 127, 202, 222 
propagation of, 220, 221 
varieties of, 222 
Floating ribs, 8 
Fluid drainage by lymphatics, 

60, 61 
Fontanelles, 6 

Food, at social functions, 148, 
149 
classification of, 87 
contamination of, 223 
cooking of, 115, 116 
digestion of, 89 
Food extracts, 99, 100 
Food supply for various tis- 
sues, ^, 87 
Foot, bones of, 12 
Footwear, 163, 170 
Foramen magnum, 8 
Foreign bodies, removal of, 

from wounds, 278 
Fractures, classification of, 
282, 283 
treatment of, 283-286 
Friction for frost-bite, 274 
Frost-bite, treatment for, 273, 

274 
Fruit, 113 



Fruit, contamination of, 114, 

223 
Fuel value of food, 91, 92, 

93 
Fur, 166, 167 
Furnace heat, 143 
Furniture, 177 

Gall-bladder, 46 

Game, 108 

Ganglionic system, 59 

Garbage, reduction of, 131 

disposal of, in country, 132 
methods of, 131, 132 
Gas lighting, 145 
Gases, proportion of, in air, 62 
Gastric juice, secretion of, 42 
Germs, body resistance to, 
198 

classification of, 193 

destruction of, in blood, 20, 
21, 195 

discovery of 192, 193 

examination of, 194 

harmless, 198, 199 

in milk loi 

ir water supply, yj^ 81, 84, 
123, 126, 127 

multiplication of, 194 

toxins of, 195, 196 

See also Infection 
Gland, 21 
Golf, 152 

Granulation of wounds, 277 
Grate fires, 138, 141 
Gravel, passage of, from kid- 
neys, 48 



INDEX 



295: 



Greenstick fracture, 283 
Gristle, 13 
Gullet, 32, 40 
Gunshot wounds, 275 
Gymnasium, 152 

Hair follicles, 51 
Hand, bones of, 10 

care of, 163 
Hard water, 72 
Hardened arteries, 25 
Haunch bones, 10, 11 
Heart, blood circulation in, 
27 

chambers of, 28 

mechanical energy of, 30 

muscle tissue of, 18 

pulsation of, 29, 30 

size and position of, 28 
Heat as disinfectant, 235 
Heat conduction of clothing, 

166, 167, 168 
Heat-stroke, 261 

treatment for, 263^ 264 
Heating, methods of, artifi- 
cial, 141 
Hellebore, 131 
Hemorrhage, 24, 25, 26, 150 

from wounds, 272, 273, 
279 

treatment for 243-249 
Hinge joint, movements of, 

13 
Horse, production of anti- 
toxin from, 196 
Horseback riding, 151 
Hot-air heating, 143 



Hot applications, for hemor- 
rhage, 246, 247 
for shock, 250, 251 

Hot springs, 71, 72 

Hot-water heating, 143 

House cleaning, methods of,. 
177, 178 

House drains, 125, 180 

House fly. See Flies 

Housemaid's knee, 12 

Humerus, 9 

Humidity, in air, 67 

Hygiene instruction in school^ 
185, 186 

Hyoid bone, 8 

Hypertrophy of muscles, 18 

Hysteria, treatment for, 261, 
262 

Ice, for heat-stroke, 264 
for hemorrhage, 246, 248,, 

259 
Icebox, care of 178, 179 
Ice supply, 84 
Ileum, 43 
Imbibition, 14, 21 
Impure air, causes of, 64 
danger of, 65, 135 
effects of, 139, 140 
Incineration of garbage, 131,. 

132 
Incised wounds, 274 
Infection, antitoxin treatment 
for, 195, 196, 197 
body resistance to, 198,23a 
by insects, 127, 153, 178, 
181, 202, 204, 206, 223; 



296 



INDEX 



Infection, carriers of, 201, 202 
fomites theory of, 199, 200 
in school, 183, 185 
in workshops, 187, 188 
of milk, loi, 22Zi 226 
of water supply, yy, 81, 84, 

123, 126, 127 
of wounds, 275 
protection against, 83, 84, 
102, 179-183, 185, 187, 
188, 190, 198, 203, 217, 
220, 223 
sources of, 201, 223 
transmission of, 193 
Ingrowing nails, 162 
Inorganic foods, 89 
Insects, as disease carriers, 
127, 153, 177, 181, 202, 
205, 206 
destruction of, in apart- 
ments, 239-241 
Insect stings, treatment for, 

281 
Insolation, 262 
Insomnia, 164 
Inspected milk, 102 
Instep, bones of, 12 

movement of, 13 
Intemperance in diet, 147-149 
Intestines, small and large, 

42-44 
Intoxication, 259, 260 
Involuntary muscles, 15 
movement of, 18 
nerve control of, 59 
lodin, tincture of, for 
wounds, 278 



Iron, for hemorrhage, 247 
Irregular bones, 5 

Jejunum, 43 
Joint oil, 15 

Joints, formation of, 13 
movements of, 13 

Kidneys, function of, 47 
size and position of, 47 
Kitchen, care of, 178, 179 
Knee-cap, 12 
Koch, 193, 226 
Kumyss, 104, 105, 106 

Lacerated wounds, 275 
Lacteals, 47 
Lake water, y6 
Lamb, 108 
Large intestine, 44 
Larynx, position of, 3^ 
Laveran, Dr., 204 
Leather clothing, 167 
Leg, bones of, 10-12 
Lemon juice, 114 

for chemical burns, 2*72 
Leukocytes, 20, 195 
Lice, 202 
Licorice, 173 
Ligaments, 14 
Lighting, methods of, 144 
Lime, chlorid of, 22,7 

in food, 89 

unslaked, 238 
Lime water for burns, 270 
Linen, 166 
Liver, functions of, 45 



INDEX 



297 



Liver, size and position of, 44, 

45 
Lobsters, 109 
Lockjaw, 17 

antitoxin for, 196 

from wounds, 289 
Long bones, construction of, 

3, 4, 5 
Luncheon, 117, 118 
Lunchrooms in workshops, 

189 
Lungs, blood circulation in, 
27 
capacity of, 36 
size and position of, 34 
wounds in, 282 
Lymphatic glands, function 

of, 61 
Lymphatic system, 60 
Lymphatics, of bone, 4 
of intestines, 47 
of muscle, 17 
of skin, 49 

Mackintoshes, 167 
Magnesia, for burns, 270 

in food, 89 
Malaria, bacteria of, 204, 205 

spleen in, 52 

transmission of, 153 
Manure, disposal of, 130,221 
Marrow, composition of, 3 
Mastication, 37, 39 
Meals, 116-118 
Measles, 183, 185, 203 
Meat, 91 

contamination of, 107, 108 



Meat, food value of, 107 
Medical examination of 
school children, 182, 

183 
Medulla oblongata, 57 
Meningitis, bacteria of, 194 
Metabolism, 90 
Metacarpus, 10 
Metatarsal bones, 12 
Microbe. See Bacteria ; 

Germs 
Microscopic Study of germs, 

194 
Milk, composition of, 100 
contamination of, loi, 103, 

223, 226 
fermentation of, 104 
preservatives of, 103 
supply of, sources of, loi, 
102 
Mineral waters, 72 
Mines, gases in, 64, 65 
Mixed diet, 90, 112, 147 
Moisture in air, 62, 63, 70 
Money, infection by old, 200 
Mosquitoes, breeding places 
of, 212-214 
extermination of, 181, 204, 

217-220 
habits of, 214-217 
hibernation of, 217 
in storage tanks, 75 
malarial, 153, 202, 205, 209, 

210 
migration of, 215, 216 
propagation of, 207, 208, 
216, 217 



298 



INDEX 



Mosquitoes, varieties of, 209- 
212 
yellow-fever, 206, 211 
Motor nerves, 57, 58 
Mouth, hemorrhage from, 

247, 248 
Movements, of joints, 13 

of spine, 6 
Mucous coat of stomach, 41, 

42 
Mucous membrane, definition 
of, 22 
of respiratory tract, 34 
Municipal disposal of gar- 
bage, 131 
Municipal inspection of sew- 
er system, 125 
Municipal regulation, of milk 
supply, 102, 106 
of ventilation, 139 
of water supply, 82, 83 
Municipal sanitary construc- 
tion, 123 
Musca domestica. See Flies 
Muscle fiber, kinds of, 15, 

18 
Muscles, arrangement of, 15 
attachment of, to bone, 17 
contraction of, 17, 18 
function of, 15 
importance of activity to, 

18 
nourishment of, 17 
number of, 15 
Muscular coat of stomach, 

41, 42 
Mutton, 108 



Nails, care of, 163 

Necrosis, 4 

Nerves, classification of, 57 

of bone, 4 

of muscle, 17 
Nervous system, function of, 

52 
Night air, 153 
Nitrogen, in air, 62, 63 

in food, 87, 88 
Non-vascular tissue, 13 
Nose bleed, treatment for, 

248 
Nourishment, transmission 

of, 23, 27 
Nutrient arteries in bones, 4 
Nutrition, by imbibition, 14, 
21 

distribution of, 19, 20 
nerve control of, 59 

of bone, 4 

of cartilage, 13, 14 

of muscles, 17 

problem of, 86 

See also Food; Diet 

Oatmeal, fuel value of, iii, 

112 
Obesity, treatment for, 119- 

121 
Offensive odors, 123, 126, 

140, 156, 157, 160, 171, 

186, 187 
destruction of, 237 
Oil lamps, 144, 145 
Olive oil for burns, 270 
Open air bathing, 159, 160 



INDEX 



299 



Open air exercise, I53-I55» 

189, 190 
Open air sleeping, 66, 165 
Open fireplaces, 141 
Oranges, 113, 114 
Organ, 21 
Organic food, ^7 
Overeating, 98, 99, 147, 149 
Oxygen, distribution of, in 
circulation, 19, 20 
in air, 62, 62, 
Oxygenation of blood, 27, 63 
Oysters, 109 
Ozone, 66, 67 

Pancreas, 46 

Pancreatic juice, secretion of, 
46, 47 

Paper towels, 188 

Parotid gland, 39 

Pasteur, 193 

Pasteur treatment for dog- 
bites, 281 

Pasteurization of milk, 102, 
103 

Patella, 12 

Peas, 112 

Pelvic bones, 10, 11 

Pelvis, 5 
construction of, 11 

Pericardium, 31 

Periosteum, 4 

Perspiration, 49, 50, 51, 92 

Petroleum for mosquitoes, 
218 

Phalanges, of foot, 12 
of hand, 10 



Pharynx, 40 

Pillows, 165, 166 

Plasma, 19, 20 

Pleura, 34 

Pleurisy, 34 

Plumbing, in modern houses, 

124, 125 
Pneumonia, bacteria of, 194 
Poisoned wounds, 275, 276 
Poisonous gases, in mines, 65, 
265 

in wells, 266 
Pons Varolii, 56 
Porosity of clothing, 167 
Potatoes, 112, 113 
Poultry, 108 
Priestley, Joseph, 62 
Privy vaults, 126, 128, 180 

proper construction of, 127 
Proteins, 87, 88, 90, 91 
Ptomain poisoning, 107 
Pulsation of heart, 29, 30 
Punctured wounds, 275 
Pylorus, 41 

Radius, 9, 10 
Rain barrel, 75 
Rain barrel mosquito, 209 
Rain water, 72, 72, 
Rectum, 44 
Red corpuscles, 20 
Red marrow, 3, 4 
Reduction of weight, 118-121 
Reserve air in lungs, 36 
Residual air in lungs, ^6 
Respiration, 31 
air supply for, 134 



300 



INDEX 



Respiration, nerve control of, 

57 
movements in, 8, g, 35 
Respiratory tract, 31, 32 

mucous membrane of, 34 
Rest rooms in workshops, 

188, 189 
Rest treatment for wounds, 

282 
Resuscitation, instructions 

for, 253-256 
Rheumatism, prevention of, 

161 
Ribs, arrangement of, 8, 9 
Rice, 112 
Rickets, 2, 87 
Rigor mortis, 17 
River water, 76, 77 
Rowing, 152 
Rubber baths, 157 
Rubber clothing, 167, 170 
Rugs, 177 
Russian baths, 159 

Sacrum, 11 

Saliva, secretion of, 39 

Salt, 89 

Salt marsh mosquito, 212 

Salt water bathing, 159 

Sanitary conditions in coun- 
try, 126-130, 132 

Sanitary construction, in 
cities, 123 
in private houses, 124, 

125 
in school buildings, 184 
in workshops, 187-191 



Sanitary precautions for tu- 
berculosis, 232, 233 
Scalds, treatment for, 272, 

273 

Scalp, hemorrhage in the, 247 

Scapula, 9 

Scarlet fever, 183, 185, 203 

School buildings, sanitation 
in, 184 

School children, hygiene in- 
struction to, 185, 186 
inspection of, 181, 182 

School corps, 183 

Schoolhouse, ventilation of, 
184 

Scurvy, 113 

Seaside excursions, 174 

Sebaceous glands, 51 

Secretion, 22 
nerve control of, 59 

Sensory nerves, 58 

Septic tanks, 129, 130 

Serous membranes, definition 
of, 22 

Serum treatment, 197 

Sewage disposal, 122, 123 

Sewer gas, protection from, 
124, 125, 266 

Sewer system, 123 

Shin bone, 11 

Shock, treatment for, 249-251 

Shoes, 163, 170 

Short bones, 5 

Shoulder blade, 9 

Sight, examination of, 162 

Silk, 166, 168 

Silver, for hemorrhage, 247 



INDEX 



301 



Skeleton, construction of, i, 

2, 5 

number of bones in, 5 
Skin, functions of, 48, 49 

glands in, 49 

structure of, 49 

waste removal from, 156, 
157 
Skull, 3, 5, 6, 8 
Sleep, amount of, 163 

body position during, 165, 
166 

purpose of, 163 

ventilation during, 164, 165 
Sleep-producing drugs, 164 
Sleeping sickness, 222 
Small intestine, digestion in, 

42, 43, 44, 46, 47 
Smallpox, 183 

vaccine for, 197 
Snake-bite, 2^6 

treatment for, 280 
Soap, 157, 177, 178 

as disinfectant, 2^2, 235, 

Soda, for burns, 270, 271 

in food, 89 
Soft water, 'J2 
Soil pipes, 124, 125 
Solicitans mosquito, 211, 212 
Special diets, 90, 91, 119-121 
Special sense, nerves of, 58 
Spinal cord, position of, 6, 57 
Spine, construction of, 6 
Spirilla, 193 
Spleen, 52 
Splint bone, 11 



Splints for fractures, 283, 
285, ^6 

Sprains, treatment for, 287, 
288 

Spring water, 75, 76 

Sputum, destruction of tuber- 
culous, 232 

Standard diet, 93, 94 

Starch for burns, 270 

Starches, 88, no, in 

Steam as disinfectant, 232, 

235 
Steam heat, 143 
Stegomyia mosquito, 206, 211 
Sternum, 8 
Stimulants, use of, in prompt 

aid to injured, 251, 258, 

263-265, 268, 274, 280 
Stomach, coats of, 41, 42 
digestion in, 41, 42 
muscular contractions of, 

41, 42 
position of, 40 
size of, 41 
Storage of water supply, yz^ 

74, 75 
Storage tanks, care of, 74, 75 
construction of, 'JZi 74, 75 
Stoves, 141, 142, 143 
Strata, passage of water 

through, 70, 71 
Striped muscles, 15 
Styptics, for hemorrhage, 247 
Sublingual gland, 39 
Submaxillary gland, 39 
Suffocation, treatment for, 

265, 266 



302 



INDEX 



Sugar, food value of, 90 

production of, in liver, 45 
Sulphur burning for insects, 

239-241 
Sulphur dioxid gas, 239-241 
Summer clothing, 170, 171 
Sun-stroke, 262 
Sweat glands, 49, 50, 51 
Sweeping, 178 
Swimming, 159, 160 
Sympathetic nervous system, 

59 . 
Syncope, 256-258 
Synovia, 15 

Synovial membranes, 14, 15 
Synovitis, 15 

Tampon for hemorrhage, 247, 

248 
Tannin, for hemorrhage, 247 
Tarsus, 12 
Tea drinking, 149 
Teeth, arrangement of, 3S 

care of, 160, 161 

formation of human, S7f 3^ 
Temperature, indoor, 143 

of baths, 158, 159 

regulation of body, 91, 92, 

93 
by perspiration, 49 
variations in, in winter, 168, 
169 
Tendons, 17 
Tennis, 152 
Tetanus, 17 
antitoxin for, 196 
from wounds, 280 



Thoracic duct, 60 
Thorax, 5 
Tibia, 11 

Tidal air in lungs^ 36 
Tobacco, 149 
Tooth powder, 161 
Touch, sense of, 49 
Tourniquet, for hemorrhage, 

245 
Towels, infection by, 187, 

188 
Toxin, 195, 196 
Trachea, structure of, 32, S3 
True skin, 49 
Tsetse fly, 222 
Tub baths, 157 
Tuberculin test, 227 
Tuberculosis, bacteria of, 194, 
226, 228 
body resistance to, 230 
bovine, 226, 227 
cures for, 230, 231 
detection of, 231, 233, 234 
prevalence of, 229, 230 
transmission of, 202, 203, 

225, 226, 227, 229 
treatment for, 65, 165, 230, 
231, 232, 233 
Turkish baths, 159 
Typhoid fever, bacteria of, 
194 
transmission of, 77, 84, loi, 

126, 127 
vaccination for, 197 
Typhoid fly, 222 
Typhus fever, transmission 
of, 202 



INDEX 



303 



Ulna, 9, 10 

Underground storage tanks, 

75 
Underground water system, 

70 
Underwear, materials of, 167, 

168 
Unstriped muscles, 15, 18 
Urea, 47 
Ureters, 48 
Urine, excretion of, 47, 48 

Vacations, 173 
Vaccine, treatment, 197 
Vacuum cleaning process, 177 
Valves, of heart, 28 

of veins, 26 
Varicose veins, 26 
Vaseline for burns, 270 
Vegetarian diet, 91 
Veins, structure of, 26 

valves of, 26 
Venous blood, 21 
Venous hemorrhage, treat- 
ment for, 243, 246 
Ventilating devices, 137, 138 
Ventilation, during sleep, 164, 

165 

effect cf bad, 139, 140 

in schools and workshops, 
134, 1B4 

municipal regulation of, 139 

of house, 135, 136 

of workshops, 191 
Ventricles, 28, 29 
Vertebme, 6 
Vesicles, 3^ 



Vinegar for chemical burns, 

272 
Vocal cords, 32 
Voluntary muscles, 15-18 
contraction of, 17 

Walking, 151-155, 189, 190 

Warm baths, 158 

Warm weather, baths in, 157 

clothing for, 170, 171 

exercise in, 155 
Waste disposal in country, 

123, 126-129, 177 
Waste matter, flies in, 127, 

130, 132, 221, 222 
Waste pipes, 124, 125 
Waste removal, in capillaries, 
26 

in circulation, 19, 20 

in kidneys, 47, 48 

in liver, 45 

in respiration, 2y, 63 

in skin, 49, 50, 51, 156 
Waste removal glands, 21 
Water, as food, 89 

composition of, 69 

drinking, 80 

passage underground of, 
70, 71 

storage of, 73, 74, 75 
Water filters, 81, 82 
Water supply, care of, 76, 77- 
79, 82, S3 

mosquitoes in, 213, 214 

on shipboard, 84 

pollution of, 73, 74, 75, 77* 
79, 84, 123, 126 



304 



INDEX 



Water supply, public protec- 
tion of, 82, 8s 
sources of, 70, ys^ 75> 7^, 
77 
Well water, 77, 78, 79 
Wells, construction of, 78, 79 

poisonous gases in, 266 
Wet weather, protection in, 

170 
Wheat, III 

White corpuscles, 20, 21, 195 
White fibrous tissue, in ar- 
terial walls, 24 
in ligaments, 14 
in tendons, 17 
Whitewash, 179 
Wind-pipe, 32 
Winter, clothing in, 168, 169 



Winter, temperature varia- 
tions in, 168, 169 
Wool, 166, 167, 168 
Workshops, sanitation in, 187- 

191 
Wounds, classification of, 
274-276 
healing of, 276, 277 
treatment of, 277-282 
Wrist, 10 
movement of, 13 

Yellow elastic tissue, in 
blood-vessels, 24, 26 
in ligaments, 14 
Yellow fever, transmission 

of, 206 
Yellow marrow, 3 



(I) 



